Assessment of Morbidity Profile and Perceptions in regards to Physical Activity amongst Display Screen Equipment Users working in a University Located in Central Rural India: A Mixed method study

Introduction

The World Health Organization (WHO) defines physical activity as any movement initiated by the skeletal muscles that requires energy expenditure. This includes all types of movement, whether during leisure, transportation, or occupational activity. Participation in both moderate- and vigorous-intensity physical activities has been demonstrated to improve overall health.¹ Devices or equipment with alphanumeric or graphic display screens such as laptops, touch screens, and similar devices are collectively referred to as display screens.² In the modern context, the majority of working adults are prone to accumulate a significant portion of their sedentary time in the workplace, surpassing the duration of sitting during leisure activities. Recognized as a distinct risk factor for adverse health outcomes, sedentary behavior is now acknowledged independently of insufficient physical activity.³ Sedentary behavior is described as activities performed while sitting or reclining, with energy expenditure not exceeding 1.5 times the basal metabolic rate. Individuals in desk-based occupations experience extended periods of high sitting times during their work hours.⁴ Lack of physical activity increases the likelihood of developing cardiovascular diseases and chronic conditions, such as diabetes, hypertension, and obesity.⁵ Nevertheless, occupational sitting stands out as the primary mover of sedentary behavior in numerous industrialized nations, leading the World Health Organization (WHO) to identify the workspace as a high priority for health promotion.³ Work-related energy expenditure has declined significantly over the last five decades, marking a shift towards increased sedentary behavior and reduced physical activity among workers. This trend is expected to persist through 2030.⁶

Healthcare professionals constitute a group facing both physical and mental burdens. The challenges of rotating work shifts, demanding tasks, and family-related responsibilities create difficulties in planning and engaging in physical exercise. Numerous studies emphasize that healthcare professionals not only lack sufficient physical activity but also engage in unhealthy dietary habits and alcohol misuse, placing them at an elevated risk of professional burnout.⁷ Individuals who extensively use computers often face a significant issue with work-related musculoskeletal disorders specifically affecting the neck among others.⁸ Extended duration of sitting in adults are commonly correlated with a heightened risk of diabetes, obesity, cardiovascular diseases, lower back pain, and increased overall mortality.⁹ Based on the report from the National Institute of Family and Health Welfare, India represents 17% of the 11 million occupational disease cases, amounting to 1.9 million cases, and 17% of the global occupational disease deaths, which total 0.12 million.¹⁰

Insufficient physical activity is responsible for 6% of global deaths, contrast to a previous study that proposed a higher estimate of 9%.⁷ There is evidence indicating that the use of digital screens is associated with dry eye disease. Additionally, the use of digital devices has been shown to alter blinking dynamics. Furthermore, it has been established that dry eye can impact the mental health and work productivity of individuals who use digital screens.¹¹ Examining physical performance differences between males and females, particularly in scenarios where time and environmental constraints impose limitations on ergonomic choices for task completion.¹² Affecting individuals from various backgrounds who use computers, computer vision syndrome has emerged as a significant public health concern, potentially evolving into an occupational epidemic in the twenty-first century.¹³ Research conducted in Loni Maharashtra, findings revealed that 93.3% of the study participants experienced more than one health issue related to computer usage. The predominant complaint was musculoskeletal problems (73.3%), followed by ocular issues (65.3%) and psychosocial concerns (46.0%). Another study conducted in India reported that 75.5% and 59.4% of respondents reported discomfort related to musculoskeletal issues and computer vision syndrome, respectively.¹⁴

Rationale

A sedentary lifestyle is a high-risk factor for the development of non-communicable diseases, such as hypertension, diabetes mellitus, dyslipidemia, stroke, and cardiovascular disease.

Display screen equipment users have an additional risk of screen time, leading to morbidities such as ophthalmic complaints, headache, vertigo, and other vision deformities.

This study assesses the pattern of physical activity level and morbidity profile simultaneously and aims to provide a holistic understanding of the health status of display screen equipment users.

This comprehensive approach allows for the identification of potential associations between sedentary behavior and health conditions among desk job workers, while qualitative inquiry with the study participants will enable a better understanding of their subjective perceptions.

Aim

Assessment of Morbidity profile and perceptions regarding Physical Activity among display screen equipment users working in a university located in central rural India.

Methods

Variable

The study variables that shall be studied are as follows:

Discussion

A cross-sectional descriptive study conducted in Mumbai by Shrivastav et al. India (2011). This study aimed to assess the prevalence of health issues among professionals in the software industry. In total, 178 participants were included in this study. The prevalence of visual is 67%, musculoskeletal is 63%, and stress is 44% are found. This study focused on ocular discomfort, musculoskeletal disorders, and psychosocial problems among computer screen users.¹⁴

The qualitative study was conducted in a United Kingdom city of a small software engineering company, on “they should stay at their desk until the work is done”: a qualitative study examining perceptions of sedentary behavior in a desk-based occupational setting to explore the desk-based office workers’ perception of factors that influence their behavior. It is essential to consider this discovery when implementing modifications that diminish sedentary behavior in the workplace.³

Gurhan Kayhan conducted a survey involving young female desk job workers to investigate the relationship between daily physical activity (PA) level and low back pain (LBP) in young women, to take an appointment for physical examination at the personal nutrition training center in Ankara, Turkey. To explore the correlation between daily physical activity levels and the occurrence of lower back pain. A total of 240 job desk women were included in the study, and the main finding was a U-shaped relationship between physical activity and lower back pain disability score in young women.⁹

Shah and colleagues conducted a cross-sectional descriptive study in Kathmandu Metropolitan City, Nepal. This study aimed to evaluate the occurrence rates of cardiovascular disease, musculoskeletal disorders, and job-related stress among individuals who use visual display screens in office settings. Among the study population, 36.7% experienced work-related stress, which was moderately challenging to manage. Additionally, this research aims to comprehend the awareness and utilization of preventive measures in this population. This study had 95% CI factors associated, and prevalence is (<0.01) was considered statistically significant.¹³

A cross-sectional study was conducted at a tertiary care hospital in New Delhi, India to evaluate work-related neck pain among individuals with desk-based occupations. The study included a total of 441 participants, revealing a higher prevalence of this burden among females than males in the desk job workforce. The primary factor identified was prolonged computer usage of 4-6 hours, which emerged as the most significant predictor for WRNP. Subsequently, work-related aspects, such as screen height and posture, were also found to be associated with WRNP.⁸

A systematic review conducted by Garlich et al. at the Cullen Eye Institute, Baylor College of Medicine, indicated that the connection between screen use and dry eye was particularly noteworthy. This is because patients experiencing dry eye may have a detrimental impact on their quality of life, potentially attributable to ocular pain and visual disturbances arising from tear film instability. The interconnection between dry eye and quality of life was observed in both health- and vision-related aspects. Furthermore, there is a correlation between dry eye and mental health, especially among individuals with an extensive use of digital screens.¹¹

Yu et al. conducted a survey on Musculoskeletal problems among visual display unit workers in an international bank in Hong Kong. A self-administered questionnaire was used to gather information pertaining to work that involved the use of a visual display unit. All 121 employees were included in the study, of whom 70 were male and 51 were female age–18-41 years. Musculoskeletal issues, particularly neck, back, shoulder, and wrist pain, were most frequently observed. Employees predominantly experienced 30% of the back pain and neck pain cases.¹⁵

Kristel Oha et al. conducted a cross-sectional investigation of individual and work-related risk factors for musculoskeletal pain in computer users at two universities in Estonia. This study aimed to assess the prevalence of musculoskeletal pain (MSP) across different body parts in the preceding year and explore its correlation with individual attributes and work-related risk factors. The study included 412 participants. High prevalence rates were observed, with neck pain being the most common at 51%, followed by low back pain at 42%, wrist/hand pain at 35%, and shoulder pain at 30%.¹⁶