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Poorworkpractices Psychosocialfactors Coldtemperaturesofairconditioners

Symptoms

Recurringmyalgiasorsorenessinshoulders,neck,upperbackorhandsandwrists

Tinglingsensationinngersand/orwrists,numbness,coldnessorlossofsensation

Lossof gripstrength,andinabilitytoholdthings,wearclothesandweakness

Musclesofarmsandshoulderfeelhard,swollen,tenderandwirywhenpalpated

Pain or numbnesswhile lying in bed that isoften mistakenlyattributedbypeopletoawkwardsleeppositions.

Types of OOS/RSI5

Type I RSI:Presenceoftypicalobjectivesignsandsymptoms.

Type II RSI: Absence of typical objective signs and symptoms

(nonspecicpainsyndrome).

Work-related upper limb disorder (WRULD):6 It is not a specicdisease,butagroupofconditionsaectingupperlimbsdiscussedunderOOS/RSI.

Type I WRULD: Itrefers to specic, localized and clearly denedsyndromes.Itincludes: Tenosynovitis(includingDeQuervainssyndrome) Triggerngerorthumb Rotatorcusyndrome oracicoutletsyndrome Carpaltunnelsyndrome Crampofthehand(Writerscramp) Epicondylitis(Tennis/Golferselbow) Bursitis Synovitis

Cervicalradiculopathy. isisthelargestgroupandisrelativelyeasytodiagnoseandtreat.

Type II WRULD: Itreferstonontraumaticupperlimbpainofunclearcauseandwithoutadenitivediagnosis.

Diagnosis

esedisordersarediculttodiagnosebecausethereisnoclearbiomedicaletiology7oravailablespecicclinicalorobjectivetests

Computer-related Illnesses andFacebook Syndrome: What are theyand How do We Tackle them?

Vitull K Gupta, Sonia Arora, Meghna Gupta

Chapter152

ehistoryofcomputersgoesasfarbackas1642whenBlackPascalinvented a mechanical calculator. First International BusinessMachines(IBM)personalcomputerwasbornin1981costingaboutUS$ 10,000.00 andsince then the development has been so fastthatnowverypowerfulcomputersareavailableataordablecosts.

Alongwithbenetsoflivinginthemoderndigitalworldofcomputertechnology, man are confronted with newer health challengesandproblems.Computer-relatedillnesses(CRIs)couldjustbethebeginningofserioushealthconcerns.1InIndia,CRIisnottreatedasanoccupationalhazardunlikeindevelopedcountriessuchastheUnited States,Canada,Australiaand United Kingdomwhere CRIsarecompensated. Indiabeing forerunnerin cyberworld, there isanurgentneedtounderstandthedynamicsoftheseproblemsandpreventthemfromassumingepidemicproportions.2

Computer-related illnesses include:

Physicalillnesses Occupational overuse syndrome (OOS)/repeated stress/strain

injuries(RSI) Computervisionsyndrome(CVS) Textneck(TN) Infertility

Sociability and interpersonal relations

Dehumanizationandotherpsychologicalimpacts Informationanxiety Jobstress Familialproblems Academicproblems Occupationalproblems

PHYSICAL ILLNESSES

Occupational Overuse Syndrome/Repeated

Stress/Strain Injuries3

is is an umbrella term for a range of conditions, which causediscomfort or persistent pain in muscles, joints, tendons, nerves

andsofttissues.SeveralothertermsareusedinterchangeablywithOOS/RSI.Halesreportedthatabout22%ofcomputerworkershavemusculoskeletalproblems.4

Factors Leading to OOS/RSI

Awkwardorconstrictedpostures Repetitivemovement Prolongedmuscletension Forcefulholdingormovement Poorergonomics

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Chapter 152 Computer-related Illnesses and Facebook SyndromeSection 22

Fordryeye,consciouslyblink,topicallubricants,punctalocclusionorpunctalpluginsertionmaybeneeded.

Text Neck16

ephraseTextNeckwascoinedbyFloridachiropractor,exercise

physiologistand entrepreneurDeanFishman.Frequentprolongedforwardexionofneckandheadcauseschangesincervicalspine,curve, supporting ligaments, tendons, musculature and bonysegments,eventuallycausingnaturalcurvatureofthenecktoreverse,potentially leading to early spinal arthritis, disc degeneration,headachesanduptoa30%decreaseinlungcapacity.Childrenaremostatriskbecausetheirheadsarelargerinrelationtotheirbodysizethanadults.

Treatment

If left untreated, TN can result in serious permanent damage.PreventionandtreatmentprinciplesarethesameasdiscussedforOOS/RSI.

Infertility

Presently,more and more computersand laptops arebeing used

leading to serious health risks including testicular damage, orreduced spermatogenesis and infertility. It is due to increasedtemperaturesinthegroinregion,17whichisduetolegpositioningtosupportalaptoponthethighs,heatgeneratedbylaptopanddirectcontactbetweenthethighandtesticleswhileworkingoncomputerforextendedperiod.

Prevention

Itcanbepreventedbyproperlegpositioning,methodsofreducingheatconductionor fans,whichmayreducetheeectsof extendedperiodsoflaptopuse.

SOCIABILITY AND INTERPERSONAL RELATIONS18-20

Whilecomputers haverevolutionizedever yaspect oflife, therehasbeen mounting concern in the literature regarding the impact ofcomputersonsociabilityandqualityoflife.

Dehumanization and Other Psychological Impacts

Manypeoplefeelalossofidentity,adehumanizationeectbecauseofcomputerizationeliminatingthehumanelementthatwaspresentin the noncomputerized systems. People are encouragedto workandshopfromtheirlivingroomscausingunfortunatepsychologicaleects,suchasdepressionandloneliness.

Information Anxiety

Informationanxietycantakeseveralforms,suchasfrustrationwithourinabilitytokeepupwiththeamountofdatapresentinourlives,frustrationwiththequalityofinformationavailableontheweb,guiltassociatedwithnotbeingbetterinformed,orbeinginformedtoolateandanxietyfrominformationoverload(toomanyonlinesources).

Job Stress

Anincreaseinworkloadand/orresponsibilitieshastriggerjobstressespeciallyforthosewhoarenotprocientwithcomputers,butwhomustworkwiththem.

Familial Problems

Marriages, dating relationships, parent-child relationships, andclosefriendshipshavebeennotedtobeseriouslydisruptedbynetbing es.21Marriagesappeartobethemostaectedasinternetuseinterferes with responsibilities and obligationsat home, and it istypicallythespousewhotakesontheseneglectedchoresandoften

especially in absence of objectiveabnormal signsand symptoms.Standardized clinical assessment includes a thorough medicalandoccupationalhistory,completephysicalexamination,cervicalscreening,posturalanalysisandactiverangeofmotionassessmentoftheupperextremity.8

TreatmentOnce a diagnosis of OOS/RSI has been made and the speciccondition has been identied, appropriate treatment requires atherapeutic intervention tailored to t the individual treatmentprogram by a multidisciplinary approach involving patient and anumberofmedicalprofessionals.Treatmentmayinclude: Restfromactivities Changingworkpractices Posturalcorrection Physiotherapy Painrelievingandanti-inammatorymedications Steroidinjections Exerciseandstretching Relaxationexercises Additional treatments that may be recommended include

massageandacupuncture Cognitive behavioral therapy (CBT), coping strategies and

psychologicalsupport.

Prevention

Occupationaloverusesyndrome(OOS)/RSIisbestpreventedinitsearlystagesbeforeitbecomesdiculttocontrol.Interventionmayneedtobemultidisciplinaryincluding: Ergonomicworkstations Maintaining correctpostureand avoidingprolonged, repetitive

activity Regularexerciseandmaintaininggeneraltness.

Computer Vision Syndrome911

Computer vision syndrome describes a group of ophthalmicsymptomsandproblemsthatresultfromprolongedcomputeruse.

Common Symptoms

Tired,irritation,burningoritchy,wateryordryeyes Blurredordoublevision Headache,heavinessofeyelidsorforehead Photophobia,dicultyinfocusing Troubleshiftingfocusbetweenmonitorandpaperdocuments Colorfringesorafterimages. PrevalenceofCVSrangesfrom25%to93%.12StudybySheedysuggeststhat1outof6patientsrequiringeyeexaminationshaveacomputer-relatedeyeproblem.13

Etiology

EtiologyofCVS ismultifactorialinvolvingenvironmental,personaloracombinationofboth.14

DiagnosisC omputer vision synd rome ca n be d ia gnosed through acomprehensivehistory,generalphysicalexaminationandthorougheyeexamination.

Treatment15

AprimarycareprovidershouldleadandcoordinatethemultisystemicevaluationofpatientswithCVSincludingergonomicfactors.Speciallensdesigns,powersorcoatingsmayhelptomaximizevisualabilitiesandcomfort.Visiontherapy(visualtraining)andeyeexerciseshelp.

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General Section 22

feels like a cyber widow andcyber aairs are causing rise indivorcecases.22

Academic Problems

Computersandinternethavebeentoutedasapremiereeducational

tool.However,onesurveyrevealedthat86%ofrespondingteachers,librariansandcomputercoordinatorsbelievethatinternetusagebychildren does not improve performance.23 Another study21 foundthat58%ofstudentsreportedadeclineinstudyhabits,asignicantdropingrades,missedclassesorbeingplacedonprobationduetoexcessiveinternetuse.

Occupational Problems

Computer and internet misuse among employees is a seriousconcernamongmanagers.Onesurveyfromthenationstop1,000companies revealed that 55% of executives believed that timesurngtheinternetfornon-businesspurposesisunderminingtheiremployeeseectivenessonthejob.

Treatment and Prevention

TreatmentandpreventionaresameasforFacebooksyndrome.

FACEBOOK SYNDROME

What is Facebook?

Facebook isa social networking service andwebsitelaunched inFebruary2004,ownedandoperatedbyFacebook,Inc.foundedbyMarkZuckerbergwithhis collegeroommatesandfellow students.enameFacebookstemsfromthecolloquialnameforthebookgiventostudentsatthestartoftheacademicyearbysomeuniversityadministrationsin theUnited States tohelp students getto knoweachother. As of May2012, Facebookhas over900 million activeusers,morethanhalfofthemusingFacebookonamobiledevice

with46.3millionmembersfromIndia.24

What is Facebook Addiction Syndrome

or Facebook Addiction Disorder?

Facebookaddictionsyndrome/Facebook addictiondisorder (FAS/FAD)isapartofinternetaddictiondisorder(IAD).InternetaddictiondisorderwasoriginallyproposedasadisorderinasatiricalhoaxbyIvan Goldberg in1995.Overthepastdecade,theconceptofIDAhasgrownin termsof acceptanceas a legitimateclinical disorderoften requiring treatment. However, known academic authoritiestakestancesineithersupportingoropposingtheexistenceofIAD.

AdebateoverwhethertoincludeInternetAddictionasadiagnosisinDiagnosticandStatisticalManualofMentalDisorders-V(DSM-V)mayconcludeintheMay2013editionoftheDSM.

Addiction

eterm addictionis notused in theDSM-IV;ratherthe termssubstancedependenceandsubstanceabuseareused.25Internetaddiction disorder may be broadly dened as the inability ofindividualstocontroltheirinternetuse,resultinginmarkeddistressand/or functional impairment in daily life.26 Conceptually, thediagnosisofIADis acompulsive-impulsivespectrumdisorderthatinvolves onlineand/or oinecomputer usage, and consists of atleastthreesubtypes:(1)excessivegaming,(2)sexualpreoccupationsand (3) e-mail/text messaging.27 E-mailing/texting has beenpredominantlyusedinsocialnetworkingandamongsocialnetworks.Facebookisbyfarthemostpopular.

Evidence of FAD/FAS/IAD

Todate,thescienticliteratureaddressingtheaddictivequalitiesofsocialnetworksontheinternetisscarce.Someofthemostinteresting

researchonIADhasbeenpublishedinSouthKoreawhereIADisconsideredoneofitsmostseriouspublichealthissues.28

Scientistshavefoundthatcompulsiveinternetusecanproducemorphologicalchangesinthestructureofthebrainwithreductionsinthesizesofdorsolateralprefrontalcortex,rostralanteriorcingulatecortex,supplementarymotorareaandpartsofcerebellumininternetaddictedstudentsascomparedtostudentsdeemednotaddicted.29

Diagnosis

Intheliterature,addictionhasinvolvedsixcorecomponentsadaptedfromtheDSM-IVtextrevision(TR)criteria30andtheInternationalClassication of Diseases-10 (ICD-10) criteria for a dependencesyndrome,31 including(1) tolerance,(2) withdrawal,(3) increaseduse,(4)lossofcontrol,(5)extendedrecoveryperiods,(6)sacricingsocial, occupational and recreational activities,and (7) continueduse despite of negative consequences. In order to be diagnosed

with social networking sites (SNSs) addiction or FAS/FAD, at leastthree(preferablymore)oftheabovementionedcriteriashouldbemetinthesame12-monthperiodandtheymustcausesignicantimpairmenttotheindividual.30

FAS/FADNew Psychological Scale32

enewpsychometrictoolreectingeachofthesixabovementionedelementsofaddictioniscalledtheBergenFacebookAddictionScale(BFAS).Itincludessixbasiccriteriawithparticipantsaskedtogiveoneofthefollowingveresponsestoeachone:(1)veryrarely,(2)rarely,(3)sometimes,(4)often,and(5)veryoften.1. YouspendalotoftimethinkingaboutFacebookorplanninghow

touseit.2. YoufeelanurgetouseFacebookmoreandmore.3. YouuseFacebookinordertoforgetaboutpersonalproblems.4. You have tried to cut down on the use of Facebook without

success.5. Youbecomerestlessortroubledifyouare prohibitedfromusing

Facebook.6. YouuseFacebooksomuchthatithashadanegativeimpacton

yourjob/studies. Andreassen andcolleagues32 suggested thatscoring oftenor

veryoftenon atleast fourof the six itemsmaysuggest thattherespondentisaddictedtoFacebook.

Facebook Depression33,34

Researchershaveproposeda newphenomenoncalledFacebookdepression, dened as depression that develops when preteensandteensspendagreatdealoftimeonsocialmediasites,suchasFacebook,andthenbegintoexhibitclassicsymptomsofdepression.

Prevention and Correction of FAS/FAD or IAD

FAD/FASorIADarenotmedicallyapprovedtermsandunfortunately,there is currentlyno standardizedtreatmentfor FAS/FAD or IAD.Unlikeotheraddictions,thegoalofIAD/FAS/FADtreatmentcannotbetotalabstinencefromusingtheinternetper sesincethelatterisanintegralelementoftodaysprofessionalandleisureculture.Correctivestrategiesinclude: Content-controlsoftware Counseling Cognitivebehavioraltherapy FollowingarethesimplestrategiestomanageandtreatFAD/FAS: RecognizethesignsofaFacebookaddiction. StartquestioningwhatyouaredoingonFacebook. Writedownexactlyhowmuchtimeyouspendoneachsite. DecidewhatisofvalueonFacebook. Giveyourselfasettimeofthedaytovisit. TrygivingupFacebookforaspeciceventtoseehowyoufare. Turnoemailnotications.

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Chapter 152 Computer-related Illnesses and Facebook SyndromeSection 22

Targetsolutionstoenablesmarter,brighterusageofFacebookinthefuture.

Becarefuloftheracetohaveasmanyfriendsaspossible. Avoid being a Facebook automaton. Every time you feel like

sayingIllFacebook you,checkyourself andrephrase thatwithIllseeyou,orIllcall you.Andmean it;itsettlesthecatch-uptimestraightaway.

MeditateassoonasthethoughtofFacebookarises. Unfortunately,internetaddictionisresistanttotreatment,entailssignicantrisks35andhashighrelapserates.Moreover,italsomakescomorbiddisorderslessresponsivetotherapy.36

CONCLUSION

Computers have the greatest impact on our lives becoming anepitomeof modern times, beingusedin everyaspect oflife. ishasalsousheredinanewgenreofcomputer-relatedoccupationalhealth problems. India being the forerunner in the cyber world,there is an urgent need to understand the dynamics of theseproblemsand preventthemfromassumingepidemicproportions.Itiseasiertopreventcomputer-relatedinjuriesthantocurethem.Certainly maladaptiveuse of internet has resulted in impairmentof individuals psychological well-being, academic failure andreduced workperformanceresulting in an entity IDA. FacebooksyndromeisapartofIAD,whichreferstotheSNSaddictionofwhichFacebookisthemostpopular.IsIAD/FAD/FASreallya21stcenturyepidemic?Is IADdevelopinginto a grave public health crisis? Isinternetdehumanizing us?Currentresearch regardingthe impactofinternetuse onmental health andhuman life isinconclusive.It leaves everyone free to speculate about dread or wonderfulconsequencesofthegrowthoftheinternet.Unfortunately,evidence-basedtreatmentforproblematicinternetuseisnotwell-establishedandexistingsourcesofhelparenotyetwidelyavailable;afactthatisnotlikelytochangewhilefundingformentalhealthservicesisonthechoppingblock.isshouldbeaccompaniedbyrapiddevelopmentofuniformdiagnosticcriteriaandavigorousresearcheortaimedatunderstandingthenatureofthiscondition.

ACKNOWLEDGMENT

Wearethank fulto MissRuplai, nalyear MBBSstudent (2009), forhervaluableinputs.

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