Computer work and musculoskeletal and asthenopic complaints among schoolteachers: A pilot study utilizing video consultation for occupational health assessment

Computer work and musculoskeletal and asthenopic complaints among schoolteachers: A pilot study utilizing video consultation for occupational health assessment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Computer work and musculoskeletal and asthenopic complaints among schoolteachers: A pilot study utilizing video consultation for occupational health assessment Peter Kegel, Elisabeth Diehl, Theresa Dicks, Pavel Dietz, Maximilian Letzel This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8270422/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Teachers increasingly rely on digital technologies and computer work for lesson preparation, administration and teaching. Computer work can be associated with musculoskeletal disorders and asthenopic complaints, particularly under unfavourable ergonomic conditions, potentially affecting teachers’ health and wellbeing. However, little is known about computer work and related health complaints in this occupational group. This pilot study examined computer work, ergonomic conditions and associated complaints among teachers, using video consultation as a tool for occupational health assessment. Methods Teachers from 36 public schools in Rhineland-Palatinate, Germany, were offered an optional occupational health screening for computer work via video consultation. During the consultation, data on computer work time at school and at home, ergonomic conditions and musculoskeletal and asthenopic complaints were collected using a structured digital questionnaire. Descriptive analyses, Mann–Whitney U tests, effect sizes and correlation analyses were conducted. Differences between teachers with and without management function were examined. Results Of the 1,453 teachers invited, 103 (7.1%) participated. Daily computer work averaged 5.0 hours (range 1–13). Teachers with a management function reported significantly longer computer work times than those without. A total of 47.6% reported at least one asthenopic symptom, most commonly dry eyes (43.7%). Shoulder/neck pain was reported by 57.3% and lower back pain by 30.1%. Significant associations were found between lower back pain and the absence of office chair armrests, between shoulder/neck pain and insufficient overhead lighting, and between asthenopic complaints and access to a height-adjustable desk. Conclusions Teachers in this pilot study performed substantial amounts of computer work and frequently reported musculoskeletal and visual complaints that may adversely affect their health and wellbeing. Teachers with management function spent more time on computer work, though even those without such roles showed considerable exposure. In line with regional occupational safety regulations, our findings support considering preventive occupational health examinations for teachers engaged in computer work. Video consultation proved advantageous for assessing real workplace conditions and provides a promising basis for tailored preventive and ergonomic measures. teachers computer work ergonomics musculoskeletal complaints asthenopic complaints occupational health video consultation wellbeing Figures Figure 1 Background A significant proportion of employees in Europe work mainly or to a large extent at computer workstations (referred to below as ‘computer work’) to perform their professional tasks [ 1 ]. Computer work is often associated with physical inactivity, which can have severe health effects, such as an increased risk of metabolic disorders, cardiovascular diseases and even mortality [ 2 , 3 ]. While epidemiologic studies on whether computer workers experience musculoskeletal disorders more frequently than other occupational groups remain inconclusive, recent evidence suggests that prolonged time performing computer work and poor ergonomic conditions can contribute to musculoskeletal disorders such as upper and/or lower back pain [ 4 , 5 ]. Other health effects of computer work may include asthenopic complaints [ 6 , 7 , 8 ]. These complaints can lead to personal suffering and impaired work performance and are already generating significant costs for the healthcare system and the economy [ 9 ]. Given the growing number of computer workstations and the lack of knowledge regarding high-risk occupational groups, risk factors and effective prevention, occupational health research is crucial for the future. Despite these known risks, certain occupational groups, such as teachers, have received limited attention in occupational health research related to computer work. Given the assumption that teachers primarily alternate between walking, standing and sitting in an ergonomically favorable manner, this occupational group has often received minimal attention in occupational health assessments, prevention programs and specific precautions related to computer work. However, recent years have seen a growing integration of digital media into educational settings, significantly increasing teachers' reliance on computer workstations [ 10 , 11 , 12 ]. This trend was further accelerated by the SARS-CoV-2 pandemic, which prompted an unprecedented shift toward digital teaching methods [ 13 ]. While educational studies have explored the pedagogical implications of this shift, there is a lack of systematic occupational health research examining the specific impacts of computer work on teachers. Occupational health care for computer work in Germany The European Union's Occupational Health and Safety Framework Directive emphasizes preventive occupational healthcare to identify and mitigate work-related health risks. In Germany, this directive is implemented through the Ordinance on Occupational Health Care (Verordnung zur Arbeitsmedizinischen Vorsorge, ArbMedVV). This framework mandates preventive care measures on the basis of risk potential, with computer work falling under optional preventive care. However, the definition of computer work within this ordinance remains broad, encompassing occasional tasks on various devices, including computers, tablets, and smartboards. The Institute for Teachers’ Health (Institut für Lehrergesundheit, IfL) is responsible for providing occupational health services to approximately 45,000 school employees in Rhineland-Palatinate. As the Institute was mandated to offer occupational health screenings for computer work as part of its services but lacked any data on the potential acceptance rate of this offer, a video consultation pilot study was designed. This pilot study aimed to answer the following research questions: 1. What is the level of interest among teachers in optional computer work screening? 2. How much time do teachers spend working on computers at school and at home, and how does this differ between teachers with and without management function? 3. What is the relationship between workplace conditions (ergonomic and computer-based) and the prevalence of back, shoulder, and neck pain, as well as eye complaints, within the study cohort? 4. Is there an association between ergonomic conditions and computer work with complaints in the eyes, back, and shoulder/neck areas? Methods To answer these research questions, a pilot study was conducted with teachers in Rhineland-Palatinate. In this study, the relevant data were collected via video consultations. Recruitment of the study cohort The selection of pilot schools was based on the population in Rhineland-Palatinate in terms of school type and size, considering a balanced regional distribution. The employees at 36 schools (N = 1,453) were sent a written offer for an occupational health screening for computer work activities. If interested, the staff could make an appointment for a video consultation with the IfL (see also the ‘Video consultation’ section). Video consultation The video consultation with a physician (duration: approx. 30–45 min.) was executed with a video consultation provider listed by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, KBV) and certified by the Federal Master Agreement for Physicians (KBV, 2024). In the run-up to the consultation, information was provided on data protection and how to conduct the video consultation. The consultation was conducted on the basis of a self-designed, digitalized medical history and documentation form, which served as a structured interview guide. The video consultation addressed the following topics: Medical history Occupational history, including ergonomic conditions and complaints Occupational health consultation Discussion of the findings and letter with occupational health recommendations Questionnaire and Measures The self-designed digital medical history and documentation form included 56 main questions with 28 clarifying follow-up questions, which were asked only if the corresponding answer was given to the main question. The medical history and documentation form guided the physician and formed the basis for the consultation documentation. A detailed overview of all the variables used for this analysis is provided in Appendix Table A1. Statistical analysis Data collected during video consultations were stored in an Access database and analyzed via IBM SPSS Statistics version 29. After a descriptive analysis and the visualization of variables, a Mann‒Whitney U test was conducted to examine the distribution of computer work time on the basis of the management function. To assess the relationships between management function and both computer device type and primary computer work activity, eta-squared (η²) effect sizes were calculated. The ANOVA results were interpreted via Cohen’s guidelines for effect sizes: small (0.01), medium (0.06) and large (0.14) ([ 14 ]). Correlation analyses were performed for back complaints, shoulder and neck complaints and the asthenopic complaints sum score. Variables from sociodemographic, ocular, health status-related and ergonomic domains were selected on the basis of their presumed association with these complaints. The following correlation measures were used: Eta-square (η²) for nominal variables Spearman’s rank correlation coefficient (ρ) for ordinal variables Pearson’s correlation coefficient (r) for metric variables The choice of correlation measures depended on the scale level of each variable. Results Out of a total of 1,453 teachers who received an offer for computer work screening, 103 participated in video consultations between December 2021 and April 2024, representing an acceptance rate of 7.1%. Descriptive results Sociodemographic characteristics Table 1 provides the descriptive results of the sociodemographic characteristics of the study cohort. The sample consisted of 74 female (71.8%) and 29 male participants (28.2%). The participants’ ages ranged from 27-64 years, with an average age of 46.1 years (SD = 8.8, median = 47). With respect to employment status, the majority were civil servants (97.1%), whereas only 2.9% were employed under other arrangements. A management position was held by 40.8% of the respondents, whereas 59.2% reported no management function. The participants represented various school types, with nearly half working at elementary schools (48.5%), followed by overall schools (14.6%), vocational and special schools (each 11.7%), grammar schools (8.7%), and secondary schools (4.9%). An overview of the socio-demographic characteristics of the study cohort compared to the overall population of school staff in Rhineland-Palatinate is provided in the appendix (Table A2). Table 1 Descriptive results of the sociodemographic characteristics of the study cohort (N=103) Sociodemographic characteristics Value Gender Female; N (%) 74 (71.8%) Male; N (%) 29 (28.2%) Age (in years); range (mean, SD, Median) 27-64 (46.1, 8.8, 47) Employment status Civil servants; N (%) 100 (97.1%) Employees; N (%) 3 (2.9%) Management function Yes; N (%) 42 (40.8%) No; N (%) 61 (59.2%) School types Vocational school; N (%) 12 (11.7%) Special school; N (%) 12 (11.7%) Elementary school; N (%) 50 (48.5%) Grammar school; N (%) 9 (8.7%) Overall school; N (%) 15 (14.6%) Secondary school; N (%) 5 (4.9%) Computer work conditions Daily computer work time ranged from 0-4 hours at home, with an average of 2.1 hours (SD = 0.9, median = 2), and from 0-10 hours at school, with an average of 2.9 hours (SD = 2.2, median = 2.5). The total daily computer work time, combining home and school use, ranged from 1-13 hours, with an average of 5.0 hours (SD = 2.3, median = 5). With respect to the main computer-related activities reported by participants, the majority used computers to prepare lessons (81.6%), followed by administrative tasks (68.0%) and teaching (39.8%). Only a small proportion indicated using computers for conferences (10.7%). In terms of devices used, most participants reported using a laptop computer (80.6%), followed by tablets (63.1%), stationary desktop computers (57.3%), and smartboards (43.7%). A comprehensive table of computer work conditions is provided in the appendix (Table A3). Ergonomic conditions Approximately 80% of the respondents reported the recommended screen distance of approximately 50–70 cm (within arm’s length), and 81.6% considered the overhead lighting at their workplace to be sufficient. A total of 76.7% of the participants indicated that they had an office chair, and nearly 79% reported that the chair was height adjustable. Among those, 92.6% adjusted the chair height to meet their personal ergonomic needs. With respect to screen positioning, 66.0% of the participants reported a straight line of sight to the screen, and 64.1% indicated that the top edge of the screen was at or below eye level. Similarly, 66.0% confirmed that their workplace was oriented parallel to the incidence of light, in line with ergonomic guidelines. Armrests were present on the office chair in 63.1% of the cases, but only 36.9% had height-adjustable armrests. Among those with adjustable armrests, approximately 78.9% had adapted them to their personal needs. A total of 7.8% of respondents reported having a height-adjustable desk. Among this subgroup, 62.5% stated that they also worked in a standing position at this workstation. For an overview, please refer to the table in the appendix (Table A4). Complaints regarding the eyes, back and shoulder‒neck areas 52.4% reported no asthenopic symptoms 32.0% reported one, 11.7% two, and 1.9% three or four symptoms. The most common individual complaint was dry eyes, reported by 43.7% of the respondents, followed by itchy eyes (10.7%), burning eyes (9.7%), and eye pain (4.9%). Complaints in the shoulder‒neck area were reported by 57.3% of the participants, whereas back pain was reported by 30.1%. An overview table can be found in the appendix (Table A5). Computer work time in relation to management function Teachers without a management function work an average of 4.36 hours a day (in total at home and at school) on a computer, whereas teachers with a management function work an average of 5.81 hours (Mann‒Whitney U test: U = 844.00, z = −2.96, p = .003). Figure 1 shows the distribution of daily computer work time at home, at school and in total for employees with and without a management function. Fig. 1 Computer work time at school, at home and in total for teachers without a management function (N=61) and with a management function (N=42) Table 2 shows the frequency distribution and effect sizes of computer and ergonomic working conditions, as well as complaints, according to management function. Significant group differences were observed, particularly in the type of computer work conditions. Individuals without a management function used computers work more often for lesson preparation (93.4% vs. 64.3%, p < .001, η² = .136), whereas those with a management function used it significantly more frequently for administrative activities (90.5% vs. 52.5%, p < .001, η² = .160) and conferences (21.4% vs. 3.3%, p = .003, η² = .083). Additionally, employees with management function used stationary computers more frequently (p = .005, η² = .077) and smartboards less frequently (p = .031, η² = .045). Regarding ergonomic conditions, teachers with a management function reported significantly more frequent access to sufficient overhead lighting (92.9% vs. 73.8%, p = .014, η² = .058), office chair armrests (78.6% vs. 52.5%, p = .007, η² = .071), and height-adjustable armrests (64.3% vs. 18.0%, p < .001, η² = .222). Other ergonomic features, such as chair adjustability, desk height, and screen positioning, did not differ significantly between groups. No significant differences were observed in asthenopic symptoms (e.g., eye strain, headache) or musculoskeletal complaints (e.g., shoulder-neck or back area pain) between individuals with and without management function. Table 2 Frequency distribution and effect sizes of computer work conditions, ergonomic conditions and complaints depending on the management function. Management function N=42 No management function N=61 P η² Computer work conditions Preparing lessons 64.3% 93.4% <0.001 0.136*** Administrative activities 90.5% 52.5% <0.001 0.160*** Teaching 31.0% 45.9% 0.130 0.023 Conferences 21.4% 3.3% 0.003 0.083** Stationary computer 73.8% 45.9% 0.005 0.077** Laptop computer 78.6% 82.0% 0.672 0.002 Tablet 52.4% 70.5% 0.062 0.034 Smartboard 31.0% 52.5% 0.031 0.045* Ergonomic conditions Distance of the screen, approximately an arm’s length 50-70 cm (yes) 78.6% 80.3% 0.830 0.000 Overhead lighting sufficient (yes) 92.9% 73.8% 0.014 0.058* Office chair (yes) 81.0% 73.8% 0.402 0.007 Office chair height-adjustable (yes) 85.7% 73.8% 0.149 0.021 Screen straight line of sight (yes) 73.8% 60.7% 0.169 0.019 Top of screen at maximum eye level (yes) 69.0% 60.7% 0.388 0.007 Workplace parallel to the incidence of light (yes) 66.7% 58.8% 0.909 0.000 Office chair armrests (yes) 78.6% 52.5% 0.007 0.071** Office chair armrests height-adjustable (yes) 64.3% 18.0% <0.001 0.222*** Height adjustable desk (yes) 4.8% 9.8% 0.349 0.009 Complaints Asthenopic symptoms sum score No symptoms 52.4% 52.5% 0.994 0.000 One symptom 32.0% 36.1% 0.296 0.011 Two symptoms 19.0% 6.6% 0.053 0.037 Three symptoms 1.9% 3.3% 0.240 0.014 Four symptoms 1.9% 1.6% 0.791 0.001 Shoulder-neck area (yes) 57.3% 59.3% 0.981 0.000 Back area (yes) 30.1% 36.1% 0.114 0.025 * p value < 0.05, ** p value < 0.01, *** p value < 0.001 Table 3 presents the correlations between physical and visual complaints and various aspects of computer work and ergonomic conditions. For lower back pain, a significant negative correlation was found with the use of office chairs equipped with armrests (ρ = -0.200, p < 0.05). In the case of shoulder and neck pain, a significant negative association was observed with sufficient overhead lighting (ρ = -0.208, p < 0.05). With respect to asthenopic complaints, a significant positive correlation was found with the use of height-adjustable desks (ρ = 0.230, p < 0.05). Table 3 Relationships between complaints and individual health factors as well as the characteristics of computer work Lower back pain Shoulder-neck-pain Asthenopic complaints sum score Computer work conditions Hours/day (total) b) -0.012 b) -0.112 a) -0.041 Preparing lessons b) -0.070 b) -0.107 b) -0.055 Administrative activities b) 0.042 b) -0.004 b) 0.123 Teaching b) -0.058 b) -0.100 b) -0.132 Conferences b) -0.090 b) -0.083 b) 0.130 Stationary computer b) -0.161 b) -0.032 b) -0.054 Laptop computer b) 0.055 b) 0.171 b) 0.060 Tablet b) 0.151 b) -0.091 b) 0.091 Smartboard b) 0.190 b) -0.031 b) -0.076 Ergonomic conditions Overhead lighting sufficient b) -0.179 b) -0.208* b) 0.108 Height-adjustable desk b) 0.126 b) 0.104 b) 0.230* Workplace parallel to the incidence of light b) -0.021 b) -0.122 b) 0.006 Office chair b) -0.089 b) -0.012 b) -0.056 Office chair height-adjustable b) -0.123 b) -0.067 b) -0.025 Office chair armrests b) -0.200 * b) -0.050 b) -0.115 Office chair armrests height-adjustable b) -0.063 b) -0.072 b) 0.015 Screen straight line of sight b) 0.069 b) 0.002 b) 0.064 Top of screen at maximum eye level b) 0.138 b) -0.115 b) -0.094 Note: a r - correlation coefficient. b ρ - Spearman’s rank correlation coefficient. * p value < 0.05, ** p value < 0.01, *** p value < 0.001. Discussion This pilot study sheds new light on teachers’ computer work patterns, the digital devices they use and their associated musculoskeletal and visual complaints. It also investigated teachers' interest in voluntary occupational healthcare and examined the practicality of carrying out such assessments via video consultation. Taken together, these findings contribute to a more comprehensive understanding of how digitalisation is shaping teachers' working conditions and health needs. From an occupational health perspective, the results are particularly relevant for risk assessment and the development of preventive strategies. Contrary to popular belief, our findings clearly show that computer work is an integral part of teachers' daily tasks, despite them not working at fixed computer workstations. Furthermore, the amount of time spent working on computers and the ergonomic conditions varied substantially, particularly between teachers with and without management responsibilities. This highlights the heterogeneity of digital work demands within the teaching profession. Importantly, the study demonstrates that occupational healthcare can be successfully delivered via video consultation. This approach allowed physicians to observe real workstation setups, identify ergonomic issues and provide personalised recommendations, offering an advantage over traditional on-site consultations. Teachers' total daily computer work time ranged from 1 to 13 hours, with an average of 5 hours per day. Such extended exposure highlights the need for structured occupational health measures that address both ergonomic issues and visual strain. Additionally, age-related visual changes may necessitate computer glasses, necessitating clear processes within occupational health services to identify and address such requirements. Computer work time Employees in management positions were found to spend significantly more time on computers than those in non-management positions. This is likely because, in addition to teaching and lesson planning, they handle administrative tasks, which are typically computer-based. Additionally, differences were observed in the distribution of computer work time between schools and homes depending on whether the person held a management function. For example, individuals with management function spend a median of four hours per day working on a computer at school, whereas those without management function spend two hours. This difference is likely due to their broader responsibilities and the fact that management staff typically have a dedicated computer workstation at school, unlike many non-management teachers do. Home computer workstation equipment and ergonomic setups also vary significantly, reflecting the diverse working conditions of teachers outside of school. Video consultation Ergonomic design and behavior-oriented prevention are crucial for maintaining a healthy work environment. A key benefit of video consultations over traditional occupational health visits is that doctors can assess workplace ergonomics and sitting posture in a person's home or office. This enables personalized, real-time feedback and tailored recommendations. From an occupational health perspective, video consultations have proven effective in providing immediate, practical advice, making them a valuable tool for improving workplace health and safety. In the future, a detailed analysis of satisfaction, as well as the advantages and disadvantages of video consultations, will be carried out. Types of Computers Used Teachers without management functions primarily used computers for lesson preparation, whereas those with management functions used them predominantly for administrative tasks, but they are also used for teaching and conferences. Employees with management function tend to use desktop computers more frequently, whereas those without management function often rely on laptops, tablets, or smartboards. From an ergonomic perspective, laptops and smartboards present unique challenges because they usually lack external keyboards and mice. Additionally, their screens, keyboards, and mice cannot be adjusted independently. This lack of adjustability can lead to discomfort and strain, so it is important to address ergonomic considerations when these devices are used. The participants in our study commonly used multiple devices, including desktop computers, notebooks, tablets, and smartboards. However, we did not track the duration of use for each device separately, which prevented us from establishing any statistical correlation between device type and shoulder/neck complaints, which is a major limitation of this study. Nonetheless, the existing scientific literature suggests that musculoskeletal complaints, particularly in the upper back, are more frequent among notebook users than among stationary computer users [ 15 ]. During consultations, it was occasionally reported that using tablets, notebooks, and smartboards in everyday school life is challenging from an ergonomic perspective. Therefore, specific ergonomic recommendations should be developed for the use of these devices in a school setting. Ergonomic Conditions Two important ergonomic parameters were reported as being present by approximately 80% of the test subjects: the recommended distance between the screen and the eyes of approximately 50–70 cm and sufficient ceiling lighting. Although these are good results for this group, achieving good ergonomics at a computer workstation also depends on other factors. These include the correct viewing angle, adjustable chairs with arm and back support, and the option of dynamic sitting and taking breaks. With respect to dynamic sitting, only 62% of our test subjects who had a height-adjustable desk also used it for standing work. Using height-adjustable desks for occasional standing work has positive effects on risk factors associated with prolonged sitting time [ 16 , 17 ]. There is therefore still significant potential for optimization and a need for advice in this area. Height-adjustable chairs and desks are primarily available to managers with dedicated office workspaces but not in classrooms. Since teaching ideally involves alternating between walking, standing, and sitting, this situation is ergonomically acceptable. However, in cases where extended periods of sitting are required in the classroom, the ergonomic setup should be optimized accordingly. The data suggest that ergonomic conditions should be addressed as part of occupational healthcare, with recommendations for improvement. According to our results, there is untapped preventive potential, particularly with respect to lighting and adjustable furniture. Further room for improvement was identified by aligning the screen with the visual axis and ensuring that the line of sight was slightly directed downward. Given the links between ergonomic strain and long-term wellbeing, these findings highlight the relevance of ergonomic prevention as part of teacher health promotion. We emphasize that occupational health advice for teachers should take into account the fact that they can often switch between walking, standing, and sitting in their everyday work—an advantage over many other occupations. This varied movement pattern has great potential for prevention and should be explicitly highlighted. Recommendations on ergonomic furniture or its optimal adjustment should not lead to health-promoting changes in posture being neglected in favor of constant sitting in a supposedly ideal position. Health complaints The prevalence of at least one symptom of asthenopia in our group was approximately 47.6%. In other professional groups, studies report a prevalence of approximately 50–80% [ 18 , 19 ]. However, these symptoms are mainly nonspecific, and the selection of symptoms considered may vary depending on the study or author. Dry eyes (43.7%) were the most frequently reported symptom, which can be explained by a reduced blink rate or incomplete eyelid closure when working with computers, which may disrupt the tear film [ 18 ]. Asthenopic complaints were significantly associated with the availability of height-adjustable desks. This may reflect reverse causation, with symptomatic individuals being more likely to request such equipment. Age had no significant effect on the sum score. In the literature, however, the influence of age on the severity of asthenopic complaints is controversial. Some studies support this correlation [ 19 ], whereas others do not [ 20 ]. In our study, total computer work time did not significantly affect the sum score of asthenopic complaints. However, total computer work time is frequently cited in the literature as an important risk factor [ 21 – 23 ]. Studies focusing on this influencing factor and related complaints among teachers are limited. For instance, Galof and Šuc examined computer workstations and related complaints from university lecturers but not schoolteachers [ 24 ]. A Japanese longitudinal study from 2007–2011 surveyed university and school staff about their office work environments and complaints, with eye fatigue, shoulder pain and lower back pain being the main symptoms [ 25 ]. Computer work times exceeding six hours and poor ergonomic sitting positions were significantly linked to these complaints. The computer usage behavior of schoolteachers may differ from that observed within other professions, and other factors in our group may have had a stronger influence than the total computer work time recorded in this study. The prevalence of lower back complaints in our study population was 30.1%, whereas shoulder and neck complaints were reported by 57.3% of the participants. In comparison, the point prevalence of lower back complaints in the general population ranges from 12% to 33% [ 26 ], depending on the study and population. The percentage of shoulder and neck complaints ranged between 0.4% and 41.5% (with an average of 14.4%). This finding indicates that shoulder–neck complaints are more common in our study group than in the general population. A study examining work-related and nonwork-related risk factors for neck complaints and lower back pain in office workers who use computers reported a one-year prevalence of 16.8% [ 4 ]. One possible explanation for this discrepancy is selection bias (individuals experiencing these complaints were more likely to have participated in the video consultation). Additionally, differences in the age distributions of the study cohorts should be considered. Another contributing factor could be that office workers typically have fixed, often ergonomically designed computer workstations, whereas teachers frequently lack these conditions. There is ongoing debate in the scientific literature about the role of ergonomic factors in musculoskeletal or asthenopic complaints at computer workstations. In our study adequate overhead lighting was negatively associated with shoulder and neck complaints, whereas the presence of armrests was negatively associated with lower back complaints. The presence of height-adjustable desks was found to be significantly associated with the total score for asthenopic complaints. The latter result could be the result of a Type I error, since as the number of statistical tests performed increases, the probability of a result being randomly significant also increases. However, this could also be due to our measurement instrument having poor validity or to uncontrolled confounding variables influencing the relationship. Furthermore, the result could be explained by reverse causation bias: individuals with asthenopic complaints are more likely to have already purchased, or been provided with, a height-adjustable desk. Therefore, for future studies, in addition to a valid measurement instrument, a longitudinal design and the consideration of confounding variables should be implemented. However, the multifactorial nature of shoulder/neck or back pain, with numerous occupational and nonoccupational influences, often results in conflicting findings or weak associations. According to Sasikumar, the most common risk factors for musculoskeletal disorders in computer work include deviation from a neutral joint angle, prolonged static positions and the duration of exposure [ 27 ]. Intervention studies have shown that proper adjustments of desk height, chair height, armrests and footrests significantly reduce upper back pain compared with that in control groups without these ergonomic interventions [ 28 ]. Inadequate lighting is also reported as a significant risk factor [ 29 ], as confirmed by the results of our study. Ergonomic lighting recommendations should be an integral part of occupational health guidance. A study by Mohseni Bandpei et al. revealed a correlation between working hours at computers and musculoskeletal complaints, but a systematic workplace anamnesis is missing [ 30 ]. Conclusions All the participating teachers spent substantial amounts of time working at computer workstations at home and at school, with daily computer working time varying widely depending on whether they had a management function. Since employees without a management function also reported significant computer work time, occupational health care should be offered to all school employees. This is not least because the teachers who participated in our study reported relevant complaints (asthenopic and shoulder-neck or back pain) that may be associated with working at a computer workstation or that may influence their work. Lower back pain was associated with missing armrests, shoulder/neck pain with insufficient lighting, and asthenopic complaints with access to height-adjustable desks (likely reflecting reverse causation). The ergonomic conditions reported by many participants indicate that preventive potential remains untapped—particularly with respect to lighting, adjustable furniture, and device-specific ergonomic challenges. Limitations The selection and composition of the study group is a potential limitation. Although the age and gender distribution of the study cohort roughly corresponded to that of the overall workforce, our study group cannot be considered representative in terms of other variables, such as the fact that 50% hold management positions. This is likely because the offer was aimed at individuals who work with a screen device. In addition, it is a relatively small sample. Compared with the total workforce in Rhineland-Palatinate, the median age of our participants was three years greater. Additionally, this was an offer of video consultation. Therefore, selection bias is likely, as individuals who rely more on computer equipment in their daily work or who experience discomfort when using such equipment may be more likely to participate. Furthermore, the data were based on self-reported information, which could result in under- or overreporting, introducing potential recall bias. Additionally, complaints about the upper or lower back were recorded as dichotomous variables, without differentiating intensity levels. These limitations underscore the need for further research, especially regarding the use of computers in schools and their impact on school staff. Declarations Ethics approval and consent to participate According to the Ethics Committee of Rhineland-Palatinate, this study did not require formal ethical approval, as all data were collected as part of the statutory occupational health mandate of the Institute for Teachers’ Health and analysed in anonymised form. Consequently, no ethics reference number was issued. All procedures were conducted in accordance with the principles of the Declaration of Helsinki. Participation in the occupational health consultation was voluntary, and informed consent was implied by participation. Participants were informed that anonymised data may be used for scientific purposes. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request ( [email protected] ). Competing interests The authors declare that they have no competing interests in relation to this study. Funding This study was conducted with internal funds from the Institute for Teachers’ Health (IfL). Author Contributions Peter Kegel, Max Letzel and Elisabeth Diehl were involved in the conception of the study. Peter Kegel, Max Letzel, Elisabeth Diehl and Theresa Dicks performed the material preparation, data collection and analysis. Peter Kegel, Elisabeth Diehl and Max Letzel wrote the first draft of the manuscript, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript. Acknowledgments We thank the researchers and staff members of the Institute for Teachers’ Health in Mainz (IfL) and of the Institute of Occupational, Social and Environmental Medicine in Mainz for their support. We also thank the Ministry of Education of Rhineland-Palatinate for their support. Supplementary information Supplementary data related to this article can be found in the Report of Teachers Health 2022/2023 (https://www.unimedizin-mainz.de/ifl/publikationen/gesundheitsbericht-forschungsberichte.html). References European Agency for Safety and Health at Work (EU-OSHA). Third European Survey of Enterprises on New and Emerging Risks (ESENER 3). Bilbao: EU-OSHA; 2019. Stamatakis E, Gale J, Bauman A, Ekelund U, Hamer M, Ding D. Sitting time, physical activity, and risk of mortality in adults. J Am Coll Cardiol. 2019;73(16):2062–72. 10.1016/j.jacc.2019.02.031 . van Uffelen JGZ, Wong J, Chau JY, van der Ploeg HP, Riphagen I, Gilson N, et al. Occupational sitting and health risks: A systematic review. Am J Prev Med. 2010;39(4):379–88. 10.1016/j.amepre.2010.05.024 . Malińska M, Bugajska J, Bartuzi P. Occupational and nonoccupational risk factors for neck and lower back pain among computer workers: A cross-sectional study. Int J Occup Saf Ergon. 2021;27(4):1108–15. 10.1080/10803548.2021.1899650 . Zemp R, Fliesser M, Wippert PM, Taylor WR, Lorenzetti S. Occupational sitting behavior and its relationship with back pain. Appl Ergon. 2016;56:84–91. 10.1016/j.apergo.2016.03.007 . Blehm C, Vishnu S, Khattak A, Mitra S, Yee RW. Computer vision syndrome: A review. Surv Ophthalmol. 2005;50(3):253–62. 10.1016/j.survophthal.2005.02.008 . Coles-Brennan C, Sulley A, Young G. Management of digital eye strain. Clin Exp Optom. 2019;102(1):18–29. 10.1111/cxo.12798 . Mataftsi A, Seliniotaki AK, Moutzouri S, Prousali E, Darusman KR, et al. Digital eye strain in young screen users: A systematic review. Prev Med. 2023;170:107493. 10.1016/j.ypmed.2023.107493 . European Agency for Safety and Health at Work (EU-OSHA). Work-related musculoskeletal disorders: Prevalence, costs and demographics in the EU. Bilbao: EU-OSHA; 2019. Bernard RM, Borokhovski E, Schmid RF, Tamim RM, Abrami PC. A meta-analysis of blended learning and technology use in higher education. J Comput High Educ. 2014;26(1):87–122. 10.1007/s12528-013-9077-3 . Bos W, Eickelmann B, Gerick J, Goldhammer F, Schaumburg H, et al. ICILS 2013 – Computer- und informationsbezogene Kompetenzen von Jugendlichen. Münster: Waxmann; 2014. Eickelmann B, Bos W, Gerick J, Goldhammer F, Schaumburg H, et al. ICILS 2018 #Deutschland. Münster: Waxmann; 2019. Zhang Z, Wasie S. Educational technology in the postpandemic era. Proc 15th Int Conf Educ Technol Comput. 2024;40–6. 10.1145/3629296.3629303 . Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale: Lawrence Erlbaum; 1988. Argus M, Pääsuke M. Musculoskeletal disorders and functional characteristics of the neck and shoulder: Comparison between office workers using a laptop or desktop computer. Work. 2023;75(4):1289–99. 10.3233/WOR-220080 . Ma J, Ma D, Li Z, Kim H. Effects of a workplace sit-stand desk intervention on health and productivity. Int J Environ Res Public Health. 2021;18(21):11604. 10.3390/ijerph182111604 . MacEwen BT, Saunders TJ, MacDonald DJ, Burr JF. Sit-stand desks to reduce workplace sitting time in office workers with abdominal obesity: A randomized controlled trial. J Phys Act Health. 2017;14(9):710–5. 10.1123/jpah.2016-0384 . Sheppard AL, Wolffsohn JS. Digital eye strain: Prevalence, measurement and amelioration. BMJ Open Ophthalmol. 2018;3:e000146. 10.1136/bmjophth-2018-000146 . Uchino M, Yokoi N, Uchino Y, Dogru M, Kawashima M, et al. Prevalence of dry eye disease among Japanese visual display terminal users. Am J Ophthalmol. 2013;156(4):759–66. 10.1016/j.ajo.2013.05.040 . Hayes JR, Sheedy JE, Stelmack JA, Heaney CA. Computer use, symptoms, and quality of life. Optom Vis Sci. 2007;84(8):738–44. 10.1097/OPX.0b013e31812f7546 . Erdinest N, Berkow D. Computer vision syndrome: A review. Harefuah. 2021;160(6):386–92. Rossi GCM, Scudeller L, Bettio F, Pasinetti GM, Bianchi PE. Prevalence of dry eye in video display terminal users. Int Ophthalmol. 2019;39(6):1315–22. 10.1007/s10792-018-0947-6 . Toomingas A, Hagberg M, Heiden M, Richter H, Westergren KE, Tornqvist EW. Symptoms from the eyes among professional computer users. Work. 2014;47(3):291–301. 10.3233/WOR-131778 . Galof K, Šuc L. Exploring teachers’ back pain: A case study. Inquiry. 2021;58:1–9. 10.1177/00469580211060256 . Maki S. Five-year survey of personal computer work and related symptoms among staff at schools and universities. Health Behav Policy Rev. 2021;8(5):394–487. 10.14485/HBPR.8.5.1 . Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37. 10.1002/art.34347 . Sasikumar V, Binoosh SC. Predicting the risk of musculoskeletal disorders in computer users. Int J Occup Saf Ergon. 2020;26(2):384–96. 10.1080/10803548.2018.1480583 . Lee S, Barros FC, Castro CSM, Oliveira Sato T. Effect of ergonomic workstation adjustments on musculoskeletal pain in office workers. Ind Health. 2021;59(2):78–85. 10.2486/indhealth.2020-0188 . Sánchez-Brau M, Domenech-Amigot B, Brocal-Fernández F, Quesada-Rico JA, Seguí-Crespo M. Computer vision syndrome in presbyopic VDT workers. Int J Environ Res Public Health. 2020;17(3):1003. 10.3390/ijerph17031003 . Mohseni Bandpei MA, Ehsani F, Behtash H, Ghanipour M. Occupational low back pain in primary and high school teachers. J Manipulative Physiol Ther. 2014;37(9):702–8. 10.1016/j.jmpt.2014.09.006 . Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":50253,"visible":true,"origin":"","legend":"\u003cp\u003eComputer work time at school, at home and in total forteachers without a management function (N=61) and with a management function (N=42)\u003c/p\u003e","description":"","filename":"Figure1Computerworktimeatschoolathomeandintotal.png","url":"https://assets-eu.researchsquare.com/files/rs-8270422/v1/35ea64a32f70a89f922c9f02.png"},{"id":103074845,"identity":"d7e16cbe-d3db-4f8d-86c5-d5504149f08d","added_by":"auto","created_at":"2026-02-20 13:11:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1066512,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8270422/v1/a53e86eb-3beb-4eb5-bc2b-c3ea3eb1d12d.pdf"},{"id":100365454,"identity":"0844b431-6d1e-4c43-8a34-7fea5a76b084","added_by":"auto","created_at":"2026-01-16 07:55:13","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":18826,"visible":true,"origin":"","legend":"","description":"","filename":"20251203manuscriptcomputerworkBMCApendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-8270422/v1/82761a96d53094c8b5a9b6b2.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Computer work and musculoskeletal and asthenopic complaints among schoolteachers: A pilot study utilizing video consultation for occupational health assessment","fulltext":[{"header":"Background","content":"\u003cp\u003eA significant proportion of employees in Europe work mainly or to a large extent at computer workstations (referred to below as \u0026lsquo;computer work\u0026rsquo;) to perform their professional tasks [\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e]. Computer work is often associated with physical inactivity, which can have severe health effects, such as an increased risk of metabolic disorders, cardiovascular diseases and even mortality [\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e]. While epidemiologic studies on whether computer workers experience musculoskeletal disorders more frequently than other occupational groups remain inconclusive, recent evidence suggests that prolonged time performing computer work and poor ergonomic conditions can contribute to musculoskeletal disorders such as upper and/or lower back pain [\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e]. Other health effects of computer work may include asthenopic complaints [\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e]. These complaints can lead to personal suffering and impaired work performance and are already generating significant costs for the healthcare system and the economy [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e]. Given the growing number of computer workstations and the lack of knowledge regarding high-risk occupational groups, risk factors and effective prevention, occupational health research is crucial for the future.\u003c/p\u003e\n\u003cp\u003eDespite these known risks, certain occupational groups, such as teachers, have received limited attention in occupational health research related to computer work. Given the assumption that teachers primarily alternate between walking, standing and sitting in an ergonomically favorable manner, this occupational group has often received minimal attention in occupational health assessments, prevention programs and specific precautions related to computer work. However, recent years have seen a growing integration of digital media into educational settings, significantly increasing teachers\u0026apos; reliance on computer workstations [\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]. This trend was further accelerated by the SARS-CoV-2 pandemic, which prompted an unprecedented shift toward digital teaching methods [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]. While educational studies have explored the pedagogical implications of this shift, there is a lack of systematic occupational health research examining the specific impacts of computer work on teachers.\u003c/p\u003e\n\u003ch3\u003eOccupational health care for computer work in Germany\u003c/h3\u003e\n\u003cp\u003eThe European Union\u0026apos;s Occupational Health and Safety Framework Directive emphasizes preventive occupational healthcare to identify and mitigate work-related health risks. In Germany, this directive is implemented through the Ordinance on Occupational Health Care (Verordnung zur Arbeitsmedizinischen Vorsorge, ArbMedVV). This framework mandates preventive care measures on the basis of risk potential, with computer work falling under optional preventive care. However, the definition of computer work within this ordinance remains broad, encompassing occasional tasks on various devices, including computers, tablets, and smartboards.\u003c/p\u003e\n\u003cp\u003eThe Institute for Teachers\u0026rsquo; Health (Institut f\u0026uuml;r Lehrergesundheit, IfL) is responsible for providing occupational health services to approximately 45,000 school employees in Rhineland-Palatinate. As the Institute was mandated to offer occupational health screenings for computer work as part of its services but lacked any data on the potential acceptance rate of this offer, a video consultation pilot study was designed.\u003c/p\u003e\n\u003cp\u003eThis pilot study aimed to answer the following research questions:\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e1. What is the level of interest among teachers in optional computer work screening?\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e2. How much time do teachers spend working on computers at school and at home, and how does this differ between teachers with and without management function?\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e3. What is the relationship between workplace conditions (ergonomic and computer-based) and the prevalence of back, shoulder, and neck pain, as well as eye complaints, within the study cohort?\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e4. Is there an association between ergonomic conditions and computer work with complaints in the eyes, back, and shoulder/neck areas?\u003c/p\u003e\n\u003c/span\u003e"},{"header":"Methods","content":"\u003cp\u003eTo answer these research questions, a pilot study was conducted with teachers in Rhineland-Palatinate. In this study, the relevant data were collected via video consultations.\u003c/p\u003e\u003ch3\u003eRecruitment of the study cohort\u003c/h3\u003e\u003cp\u003eThe selection of pilot schools was based on the population in Rhineland-Palatinate in terms of school type and size, considering a balanced regional distribution. The employees at 36 schools (N = 1,453) were sent a written offer for an occupational health screening for computer work activities. If interested, the staff could make an appointment for a video consultation with the IfL (see also the ‘Video consultation’ section).\u003c/p\u003e\u003ch3\u003eVideo consultation\u003c/h3\u003e\u003cp\u003eThe video consultation with a physician (duration: approx. 30–45 min.) was executed with a video consultation provider listed by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, KBV) and certified by the Federal Master Agreement for Physicians (KBV, 2024). In the run-up to the consultation, information was provided on data protection and how to conduct the video consultation. The consultation was conducted on the basis of a self-designed, digitalized medical history and documentation form, which served as a structured interview guide. The video consultation addressed the following topics:\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003eMedical history\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eOccupational history, including ergonomic conditions and complaints\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eOccupational health consultation\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDiscussion of the findings and letter with occupational health recommendations\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003ch3\u003eQuestionnaire and Measures\u003c/h3\u003e\u003cp\u003eThe self-designed digital medical history and documentation form included 56 main questions with 28 clarifying follow-up questions, which were asked only if the corresponding answer was given to the main question. The medical history and documentation form guided the physician and formed the basis for the consultation documentation. A detailed overview of all the variables used for this analysis is provided in Appendix Table A1.\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eData collected during video consultations were stored in an Access database and analyzed via IBM SPSS Statistics version 29. After a descriptive analysis and the visualization of variables, a Mann‒Whitney U test was conducted to examine the distribution of computer work time on the basis of the management function. To assess the relationships between management function and both computer device type and primary computer work activity, eta-squared (η²) effect sizes were calculated. The ANOVA results were interpreted via Cohen’s guidelines for effect sizes: small (0.01), medium (0.06) and large (0.14) ([\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]).\u003c/p\u003e\u003cp\u003eCorrelation analyses were performed for back complaints, shoulder and neck complaints and the asthenopic complaints sum score. Variables from sociodemographic, ocular, health status-related and ergonomic domains were selected on the basis of their presumed association with these complaints. The following correlation measures were used:\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003eEta-square (η²) for nominal variables\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSpearman’s rank correlation coefficient (ρ) for ordinal variables\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePearson’s correlation coefficient (r) for metric variables\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003cp\u003eThe choice of correlation measures depended on the scale level of each variable.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of a total of 1,453 teachers who received an offer for computer work screening, 103 participated in video consultations between December 2021 and April 2024, representing an acceptance rate of 7.1%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDescriptive results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eSociodemographic\u003c/u\u003e\u003cu\u003e\u0026nbsp;characteristics\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 provides the descriptive results of the sociodemographic characteristics of the study cohort. The sample consisted of 74 female (71.8%) and 29 male participants (28.2%). The participants\u0026rsquo; ages ranged from 27-64 years, with an average age of 46.1 years (SD = 8.8, median = 47). With respect to employment status, the majority were civil servants (97.1%), whereas only 2.9% were employed under other arrangements. A management position was held by 40.8% of the respondents, whereas 59.2% reported no management function. The participants represented various school types, with nearly half working at elementary schools (48.5%), followed by overall schools (14.6%), vocational and special schools (each 11.7%), grammar schools (8.7%), and secondary schools (4.9%). An overview of the socio-demographic characteristics of the study cohort compared to the overall population of school staff in Rhineland-Palatinate is provided in the appendix (Table A2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e Descriptive results of the sociodemographic characteristics of the study cohort (N=103)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociodemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eValue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eFemale; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e74 (71.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eMale; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e29 (28.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (in years); range (mean, SD, Median)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e27-64 (46.1, 8.8, 47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eCivil servants; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e100 (97.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eEmployees; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e3 (2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eManagement function\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eYes; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e42 (40.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eNo; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e61 (59.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchool types\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eVocational school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e12 (11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eSpecial school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e12 (11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eElementary school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e50 (48.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eGrammar school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e9 (8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eOverall school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e15 (14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.2479%;\"\u003e\n \u003cp\u003eSecondary school; N (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.7521%;\"\u003e\n \u003cp\u003e5 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cu\u003eComputer work conditions\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eDaily computer work time ranged from 0-4 hours at home, with an average of 2.1 hours (SD = 0.9, median = 2), and from 0-10 hours at school, with an average of 2.9 hours (SD = 2.2, median = 2.5). The total daily computer work time, combining home and school use, ranged from 1-13 hours, with an average of 5.0 hours (SD = 2.3, median = 5).\u003c/p\u003e\n\u003cp\u003eWith respect to the main computer-related activities reported by participants, the majority used computers to prepare lessons (81.6%), followed by administrative tasks (68.0%) and teaching (39.8%). Only a small proportion indicated using computers for conferences (10.7%). In terms of devices used, most participants reported using a laptop computer (80.6%), followed by tablets (63.1%), stationary desktop computers (57.3%), and smartboards (43.7%). A comprehensive table of computer work conditions is provided in the appendix (Table A3).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eErgonomic conditions\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eApproximately 80% of the respondents reported the recommended screen distance of approximately 50\u0026ndash;70 cm (within arm\u0026rsquo;s length), and 81.6% considered the overhead lighting at their workplace to be sufficient. A total of 76.7% of the participants indicated that they had an office chair, and nearly 79% reported that the chair was height adjustable. Among those, 92.6% adjusted the chair height to meet their personal ergonomic needs.\u003c/p\u003e\n\u003cp\u003eWith respect to screen positioning, 66.0% of the participants reported a straight line of sight to the screen, and 64.1% indicated that the top edge of the screen was at or below eye level. Similarly, 66.0% confirmed that their workplace was oriented parallel to the incidence of light, in line with ergonomic guidelines.\u003c/p\u003e\n\u003cp\u003eArmrests were present on the office chair in 63.1% of the cases, but only 36.9% had height-adjustable armrests. Among those with adjustable armrests, approximately 78.9% had adapted them to their personal needs.\u003c/p\u003e\n\u003cp\u003eA total of 7.8% of respondents reported having a height-adjustable desk. Among this subgroup, 62.5% stated that they also worked in a standing position at this workstation. For an overview, please refer to the table in the appendix (Table A4).\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eComplaints\u003cem\u003e\u0026nbsp;\u003c/em\u003eregarding the eyes, back and\u0026nbsp;\u003c/u\u003e\u003cu\u003eshoulder‒neck areas\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e52.4% reported no asthenopic symptoms 32.0% reported one, 11.7% two, and 1.9% three or four symptoms. The most common individual complaint was dry eyes, reported by 43.7% of the respondents, followed by itchy eyes (10.7%), burning eyes (9.7%), and eye pain (4.9%).\u003c/p\u003e\n\u003cp\u003eComplaints in the shoulder‒neck area were reported by 57.3% of the participants, whereas back pain was reported by 30.1%. An overview table can be found in the appendix (Table A5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComputer work time in relation to management function\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTeachers without a management function work an average of 4.36 hours a day (in total at home and at school) on a computer, whereas teachers with a management function work an average of 5.81 hours (Mann‒Whitney U test: \u003cem\u003eU\u003c/em\u003e = 844.00, \u003cem\u003ez\u003c/em\u003e = \u0026minus;2.96, \u003cem\u003ep\u003c/em\u003e = .003). Figure 1 shows the distribution of daily computer work time at home, at school and in total for employees with and without a management function.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFig. 1\u003c/strong\u003e Computer work time at school, at home and in total for teachers without a management function (N=61) and with a management function (N=42)\u003c/p\u003e\n\u003cp\u003eTable 2 shows the frequency distribution and effect sizes of computer and ergonomic working conditions, as well as complaints, according to management function.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSignificant group differences were observed, particularly in the type of computer work conditions. Individuals without a management function used computers work more often for lesson preparation (93.4% vs. 64.3%, p \u0026lt; .001, \u0026eta;\u0026sup2; = .136), whereas those with a management function used it significantly more frequently for administrative activities (90.5% vs. 52.5%, p \u0026lt; .001, \u0026eta;\u0026sup2; = .160) and conferences (21.4% vs. 3.3%, p = .003, \u0026eta;\u0026sup2; = .083). Additionally, employees with management function used stationary computers more frequently (p = .005, \u0026eta;\u0026sup2; = .077) and smartboards less frequently (p = .031, \u0026eta;\u0026sup2; = .045).\u003c/p\u003e\n\u003cp\u003eRegarding ergonomic conditions, teachers with a management function reported significantly more frequent access to sufficient overhead lighting (92.9% vs. 73.8%, p = .014, \u0026eta;\u0026sup2; = .058), office chair armrests (78.6% vs. 52.5%, p = .007, \u0026eta;\u0026sup2; = .071), and height-adjustable armrests (64.3% vs. 18.0%, p \u0026lt; .001, \u0026eta;\u0026sup2; = .222). Other ergonomic features, such as chair adjustability, desk height, and screen positioning, did not differ significantly between groups.\u003c/p\u003e\n\u003cp\u003eNo significant differences were observed in asthenopic symptoms (e.g., eye strain, headache) or musculoskeletal complaints (e.g., shoulder-neck or back area pain) between individuals with and without management function.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eFrequency distribution and effect sizes of computer work conditions, ergonomic conditions and complaints depending on the management function.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1012\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 30.2372%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 35.8696%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eManagement function\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=42\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo management function\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=61\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026eta;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComputer work conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003ePreparing lessons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e64.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e93.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.136***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eAdministrative activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e90.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e52.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.160***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eTeaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e31.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e45.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eConferences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e21.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.083**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eStationary computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e45.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.077**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eLaptop computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e78.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e82.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eTablet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e52.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e70.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eSmartboard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e31.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e52.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.045*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eErgonomic conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eDistance of the screen, approximately an arm\u0026rsquo;s length 50-70 cm (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e78.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e80.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.830\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eOverhead lighting sufficient (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e92.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.058*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eOffice chair (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e81.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.402\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eOffice chair height-adjustable (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e85.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eScreen straight line of sight (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e60.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eTop of screen at maximum eye level (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e69.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e60.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.388\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eWorkplace parallel to the incidence of light (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e58.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eOffice chair armrests (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e78.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e52.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.071**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eOffice chair armrests height-adjustable (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e64.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e18.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.222***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eHeight adjustable desk (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e4.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e9.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplaints\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAsthenopic symptoms sum score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 3.95257%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.1739%;\"\u003e\n \u003cp\u003eNo symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e52.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e52.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 3.95257%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.1739%;\"\u003e\n \u003cp\u003eOne symptom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e32.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e36.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 3.95257%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.1739%;\"\u003e\n \u003cp\u003eTwo symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e19.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e6.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 3.95257%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.1739%;\"\u003e\n \u003cp\u003eThree symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e1.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 3.95257%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 27.1739%;\"\u003e\n \u003cp\u003eFour symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e1.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e1.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eShoulder-neck area (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e57.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e59.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.981\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.1265%;\"\u003e\n \u003cp\u003eBack area (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.9802%;\"\u003e\n \u003cp\u003e30.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8854%;\"\u003e\n \u003cp\u003e36.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.63241%;\"\u003e\n \u003cp\u003e0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3755%;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* p value \u0026lt; 0.05, ** p value \u0026lt; 0.01, *** p value \u0026lt; 0.001\u003c/p\u003e\n\u003cp\u003eTable 3 presents the correlations between physical and visual complaints and various aspects of computer work and ergonomic conditions. For lower back pain, a significant negative correlation was found with the use of office chairs equipped with armrests (\u0026rho; = -0.200, p \u0026lt; 0.05). In the case of shoulder and neck pain, a significant negative association was observed with sufficient overhead lighting (\u0026rho; = -0.208, p \u0026lt; 0.05). With respect to asthenopic complaints, a significant positive correlation was found with the use of height-adjustable desks (\u0026rho; = 0.230, p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e Relationships between complaints and individual health factors as well as the characteristics of computer work\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower back pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShoulder-neck-pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAsthenopic complaints sum score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComputer work conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eHours/day (total)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003ea)\u003c/sup\u003e -0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003ePreparing lessons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eAdministrative activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.123\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eTeaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eConferences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eStationary computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eLaptop computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e 0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eTablet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eSmartboard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u003c/sup\u003e 0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eErgonomic conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eOverhead lighting sufficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e\u003cstrong\u003e-0.208*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eHeight-adjustable desk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e\u003cstrong\u003e0.230*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eWorkplace parallel to the incidence of light\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eOffice chair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eOffice chair height-adjustable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eOffice chair armrests\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e\u003cstrong\u003e-0.200\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eOffice chair armrests height-adjustable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eScreen straight line of sight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.2513%;\"\u003e\n \u003cp\u003eTop of screen at maximum eye level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.5829%;\"\u003e\n \u003cp\u003e\u003csup\u003eb)\u0026nbsp;\u003c/sup\u003e-0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003csup\u003ea\u003c/sup\u003er - correlation coefficient. \u003csup\u003eb\u003c/sup\u003e\u0026rho; -\u0026nbsp;Spearman\u0026rsquo;s rank correlation coefficient.\u0026nbsp;* p value \u0026lt; 0.05, ** p value \u0026lt; 0.01, *** p value \u0026lt; 0.001.\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis pilot study sheds new light on teachers\u0026rsquo; computer work patterns, the digital devices they use and their associated musculoskeletal and visual complaints. It also investigated teachers' interest in voluntary occupational healthcare and examined the practicality of carrying out such assessments via video consultation. Taken together, these findings contribute to a more comprehensive understanding of how digitalisation is shaping teachers' working conditions and health needs.\u003c/p\u003e \u003cp\u003eFrom an occupational health perspective, the results are particularly relevant for risk assessment and the development of preventive strategies. Contrary to popular belief, our findings clearly show that computer work is an integral part of teachers' daily tasks, despite them not working at fixed computer workstations. Furthermore, the amount of time spent working on computers and the ergonomic conditions varied substantially, particularly between teachers with and without management responsibilities. This highlights the heterogeneity of digital work demands within the teaching profession.\u003c/p\u003e \u003cp\u003eImportantly, the study demonstrates that occupational healthcare can be successfully delivered via video consultation. This approach allowed physicians to observe real workstation setups, identify ergonomic issues and provide personalised recommendations, offering an advantage over traditional on-site consultations.\u003c/p\u003e \u003cp\u003eTeachers' total daily computer work time ranged from 1 to 13 hours, with an average of 5 hours per day. Such extended exposure highlights the need for structured occupational health measures that address both ergonomic issues and visual strain. Additionally, age-related visual changes may necessitate computer glasses, necessitating clear processes within occupational health services to identify and address such requirements.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eComputer work time\u003c/h2\u003e \u003cp\u003eEmployees in management positions were found to spend significantly more time on computers than those in non-management positions. This is likely because, in addition to teaching and lesson planning, they handle administrative tasks, which are typically computer-based. Additionally, differences were observed in the distribution of computer work time between schools and homes depending on whether the person held a management function. For example, individuals with management function spend a median of four hours per day working on a computer at school, whereas those without management function spend two hours. This difference is likely due to their broader responsibilities and the fact that management staff typically have a dedicated computer workstation at school, unlike many non-management teachers do. Home computer workstation equipment and ergonomic setups also vary significantly, reflecting the diverse working conditions of teachers outside of school.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eVideo consultation\u003c/h2\u003e \u003cp\u003eErgonomic design and behavior-oriented prevention are crucial for maintaining a healthy work environment. A key benefit of video consultations over traditional occupational health visits is that doctors can assess workplace ergonomics and sitting posture in a person's home or office. This enables personalized, real-time feedback and tailored recommendations. From an occupational health perspective, video consultations have proven effective in providing immediate, practical advice, making them a valuable tool for improving workplace health and safety. In the future, a detailed analysis of satisfaction, as well as the advantages and disadvantages of video consultations, will be carried out.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eTypes of Computers Used\u003c/h2\u003e \u003cp\u003eTeachers without management functions primarily used computers for lesson preparation, whereas those with management functions used them predominantly for administrative tasks, but they are also used for teaching and conferences. Employees with management function tend to use desktop computers more frequently, whereas those without management function often rely on laptops, tablets, or smartboards. From an ergonomic perspective, laptops and smartboards present unique challenges because they usually lack external keyboards and mice. Additionally, their screens, keyboards, and mice cannot be adjusted independently. This lack of adjustability can lead to discomfort and strain, so it is important to address ergonomic considerations when these devices are used. The participants in our study commonly used multiple devices, including desktop computers, notebooks, tablets, and smartboards. However, we did not track the duration of use for each device separately, which prevented us from establishing any statistical correlation between device type and shoulder/neck complaints, which is a major limitation of this study. Nonetheless, the existing scientific literature suggests that musculoskeletal complaints, particularly in the upper back, are more frequent among notebook users than among stationary computer users [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. During consultations, it was occasionally reported that using tablets, notebooks, and smartboards in everyday school life is challenging from an ergonomic perspective. Therefore, specific ergonomic recommendations should be developed for the use of these devices in a school setting.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eErgonomic Conditions\u003c/h2\u003e \u003cp\u003eTwo important ergonomic parameters were reported as being present by approximately 80% of the test subjects: the recommended distance between the screen and the eyes of approximately 50\u0026ndash;70 cm and sufficient ceiling lighting. Although these are good results for this group, achieving good ergonomics at a computer workstation also depends on other factors. These include the correct viewing angle, adjustable chairs with arm and back support, and the option of dynamic sitting and taking breaks.\u003c/p\u003e \u003cp\u003eWith respect to dynamic sitting, only 62% of our test subjects who had a height-adjustable desk also used it for standing work. Using height-adjustable desks for occasional standing work has positive effects on risk factors associated with prolonged sitting time [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. There is therefore still significant potential for optimization and a need for advice in this area. Height-adjustable chairs and desks are primarily available to managers with dedicated office workspaces but not in classrooms. Since teaching ideally involves alternating between walking, standing, and sitting, this situation is ergonomically acceptable. However, in cases where extended periods of sitting are required in the classroom, the ergonomic setup should be optimized accordingly. The data suggest that ergonomic conditions should be addressed as part of occupational healthcare, with recommendations for improvement. According to our results, there is untapped preventive potential, particularly with respect to lighting and adjustable furniture. Further room for improvement was identified by aligning the screen with the visual axis and ensuring that the line of sight was slightly directed downward. Given the links between ergonomic strain and long-term wellbeing, these findings highlight the relevance of ergonomic prevention as part of teacher health promotion.\u003c/p\u003e \u003cp\u003eWe emphasize that occupational health advice for teachers should take into account the fact that they can often switch between walking, standing, and sitting in their everyday work\u0026mdash;an advantage over many other occupations. This varied movement pattern has great potential for prevention and should be explicitly highlighted. Recommendations on ergonomic furniture or its optimal adjustment should not lead to health-promoting changes in posture being neglected in favor of constant sitting in a supposedly ideal position.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eHealth complaints\u003c/h2\u003e \u003cp\u003eThe prevalence of at least one symptom of asthenopia in our group was approximately 47.6%. In other professional groups, studies report a prevalence of approximately 50\u0026ndash;80% [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. However, these symptoms are mainly nonspecific, and the selection of symptoms considered may vary depending on the study or author. Dry eyes (43.7%) were the most frequently reported symptom, which can be explained by a reduced blink rate or incomplete eyelid closure when working with computers, which may disrupt the tear film [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAsthenopic complaints were significantly associated with the availability of height-adjustable desks. This may reflect reverse causation, with symptomatic individuals being more likely to request such equipment. Age had no significant effect on the sum score. In the literature, however, the influence of age on the severity of asthenopic complaints is controversial. Some studies support this correlation [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], whereas others do not [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, total computer work time did not significantly affect the sum score of asthenopic complaints. However, total computer work time is frequently cited in the literature as an important risk factor [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Studies focusing on this influencing factor and related complaints among teachers are limited. For instance, Galof and Šuc examined computer workstations and related complaints from university lecturers but not schoolteachers [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. A Japanese longitudinal study from 2007\u0026ndash;2011 surveyed university and school staff about their office work environments and complaints, with eye fatigue, shoulder pain and lower back pain being the main symptoms [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Computer work times exceeding six hours and poor ergonomic sitting positions were significantly linked to these complaints. The computer usage behavior of schoolteachers may differ from that observed within other professions, and other factors in our group may have had a stronger influence than the total computer work time recorded in this study.\u003c/p\u003e \u003cp\u003eThe prevalence of lower back complaints in our study population was 30.1%, whereas shoulder and neck complaints were reported by 57.3% of the participants. In comparison, the point prevalence of lower back complaints in the general population ranges from 12% to 33% [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], depending on the study and population. The percentage of shoulder and neck complaints ranged between 0.4% and 41.5% (with an average of 14.4%). This finding indicates that shoulder\u0026ndash;neck complaints are more common in our study group than in the general population. A study examining work-related and nonwork-related risk factors for neck complaints and lower back pain in office workers who use computers reported a one-year prevalence of 16.8% [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. One possible explanation for this discrepancy is selection bias (individuals experiencing these complaints were more likely to have participated in the video consultation). Additionally, differences in the age distributions of the study cohorts should be considered. Another contributing factor could be that office workers typically have fixed, often ergonomically designed computer workstations, whereas teachers frequently lack these conditions.\u003c/p\u003e \u003cp\u003eThere is ongoing debate in the scientific literature about the role of ergonomic factors in musculoskeletal or asthenopic complaints at computer workstations. In our study adequate overhead lighting was negatively associated with shoulder and neck complaints, whereas the presence of armrests was negatively associated with lower back complaints. The presence of height-adjustable desks was found to be significantly associated with the total score for asthenopic complaints. The latter result could be the result of a Type I error, since as the number of statistical tests performed increases, the probability of a result being randomly significant also increases. However, this could also be due to our measurement instrument having poor validity or to uncontrolled confounding variables influencing the relationship. Furthermore, the result could be explained by reverse causation bias: individuals with asthenopic complaints are more likely to have already purchased, or been provided with, a height-adjustable desk. Therefore, for future studies, in addition to a valid measurement instrument, a longitudinal design and the consideration of confounding variables should be implemented. However, the multifactorial nature of shoulder/neck or back pain, with numerous occupational and nonoccupational influences, often results in conflicting findings or weak associations. According to Sasikumar, the most common risk factors for musculoskeletal disorders in computer work include deviation from a neutral joint angle, prolonged static positions and the duration of exposure [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Intervention studies have shown that proper adjustments of desk height, chair height, armrests and footrests significantly reduce upper back pain compared with that in control groups without these ergonomic interventions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Inadequate lighting is also reported as a significant risk factor [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], as confirmed by the results of our study. Ergonomic lighting recommendations should be an integral part of occupational health guidance. A study by Mohseni Bandpei et al. revealed a correlation between working hours at computers and musculoskeletal complaints, but a systematic workplace anamnesis is missing [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eAll the participating teachers spent substantial amounts of time working at computer workstations at home and at school, with daily computer working time varying widely depending on whether they had a management function. Since employees without a management function also reported significant computer work time, occupational health care should be offered to all school employees. This is not least because the teachers who participated in our study reported relevant complaints (asthenopic and shoulder-neck or back pain) that may be associated with working at a computer workstation or that may influence their work. Lower back pain was associated with missing armrests, shoulder/neck pain with insufficient lighting, and asthenopic complaints with access to height-adjustable desks (likely reflecting reverse causation). The ergonomic conditions reported by many participants indicate that preventive potential remains untapped\u0026mdash;particularly with respect to lighting, adjustable furniture, and device-specific ergonomic challenges.\u003c/p\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe selection and composition of the study group is a potential limitation. Although the age and gender distribution of the study cohort roughly corresponded to that of the overall workforce, our study group cannot be considered representative in terms of other variables, such as the fact that 50% hold management positions. This is likely because the offer was aimed at individuals who work with a screen device. In addition, it is a relatively small sample. Compared with the total workforce in Rhineland-Palatinate, the median age of our participants was three years greater. Additionally, this was an offer of video consultation. Therefore, selection bias is likely, as individuals who rely more on computer equipment in their daily work or who experience discomfort when using such equipment may be more likely to participate. Furthermore, the data were based on self-reported information, which could result in under- or overreporting, introducing potential recall bias. Additionally, complaints about the upper or lower back were recorded as dichotomous variables, without differentiating intensity levels. These limitations underscore the need for further research, especially regarding the use of computers in schools and their impact on school staff.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the Ethics Committee of Rhineland-Palatinate, this study did not require formal ethical approval, as all data were collected as part of the statutory occupational health mandate of the Institute for Teachers\u0026rsquo; Health and analysed in anonymised form. Consequently, no ethics reference number was issued. All procedures were conducted in accordance with the principles of the Declaration of Helsinki. Participation in the occupational health consultation was voluntary, and informed consent was implied by participation. Participants were informed that anonymised data may be used for scientific purposes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request ([email protected]).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests in relation to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted with internal funds from the Institute for Teachers\u0026rsquo; Health (IfL).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePeter Kegel, Max Letzel and Elisabeth Diehl were involved in the conception of the study. Peter Kegel, Max Letzel, Elisabeth Diehl and Theresa Dicks performed the material preparation, data collection and analysis. Peter Kegel, Elisabeth Diehl and Max Letzel wrote the first draft of the manuscript, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the researchers and staff members of the Institute for Teachers\u0026rsquo; Health in Mainz (IfL) and of the Institute of Occupational, Social and Environmental Medicine in Mainz for their support. We also thank the Ministry of Education of Rhineland-Palatinate for their support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupplementary information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSupplementary data related to this article can be found in the Report of Teachers Health 2022/2023 (https://www.unimedizin-mainz.de/ifl/publikationen/gesundheitsbericht-forschungsberichte.html).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEuropean Agency for Safety and Health at Work (EU-OSHA). Third European Survey of Enterprises on New and Emerging Risks (ESENER 3). Bilbao: EU-OSHA; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStamatakis E, Gale J, Bauman A, Ekelund U, Hamer M, Ding D. Sitting time, physical activity, and risk of mortality in adults. 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J Manipulative Physiol Ther. 2014;37(9):702\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jmpt.2014.09.006\u003c/span\u003e\u003cspan address=\"10.1016/j.jmpt.2014.09.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"teachers, computer work, ergonomics, musculoskeletal complaints, asthenopic complaints, occupational health, video consultation, wellbeing","lastPublishedDoi":"10.21203/rs.3.rs-8270422/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8270422/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eTeachers increasingly rely on digital technologies and computer work for lesson preparation, administration and teaching. Computer work can be associated with musculoskeletal disorders and asthenopic complaints, particularly under unfavourable ergonomic conditions, potentially affecting teachers\u0026rsquo; health and wellbeing. However, little is known about computer work and related health complaints in this occupational group. This pilot study examined computer work, ergonomic conditions and associated complaints among teachers, using video consultation as a tool for occupational health assessment.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eTeachers from 36 public schools in Rhineland-Palatinate, Germany, were offered an optional occupational health screening for computer work via video consultation. During the consultation, data on computer work time at school and at home, ergonomic conditions and musculoskeletal and asthenopic complaints were collected using a structured digital questionnaire. Descriptive analyses, Mann\u0026ndash;Whitney U tests, effect sizes and correlation analyses were conducted. Differences between teachers with and without management function were examined.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 1,453 teachers invited, 103 (7.1%) participated. Daily computer work averaged 5.0 hours (range 1\u0026ndash;13). Teachers with a management function reported significantly longer computer work times than those without. A total of 47.6% reported at least one asthenopic symptom, most commonly dry eyes (43.7%). Shoulder/neck pain was reported by 57.3% and lower back pain by 30.1%. Significant associations were found between lower back pain and the absence of office chair armrests, between shoulder/neck pain and insufficient overhead lighting, and between asthenopic complaints and access to a height-adjustable desk.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eTeachers in this pilot study performed substantial amounts of computer work and frequently reported musculoskeletal and visual complaints that may adversely affect their health and wellbeing. Teachers with management function spent more time on computer work, though even those without such roles showed considerable exposure. In line with regional occupational safety regulations, our findings support considering preventive occupational health examinations for teachers engaged in computer work. Video consultation proved advantageous for assessing real workplace conditions and provides a promising basis for tailored preventive and ergonomic measures.\u003c/p\u003e","manuscriptTitle":"Computer work and musculoskeletal and asthenopic complaints among schoolteachers: A pilot study utilizing video consultation for occupational health assessment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-13 07:10:20","doi":"10.21203/rs.3.rs-8270422/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"eed74b7b-7a76-40e2-8a8a-35f2bc859525","owner":[],"postedDate":"January 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-20T13:10:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-13 07:10:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8270422","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8270422","identity":"rs-8270422","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}