Improved indoor lighting improved healthy aging at home - an intervention study in 77-year-old Norwegians.

Introduction: Healthy aging and good quality of life is important to allow older people to live at home. Lighting is a significant environmental attribute promoting visual, physical, and mental health. Due to normal visual age changes, older people need more light, but improving indoor lighting levels receives little attention. Objective: To investigate the impact of improved home lighting on abilities to perform activities of daily living (ADLs) and quality of life in healthy older people. Methods: Sixty healthy 77 years old living at home participated during the 4-month dark winter period. In the intervention group (IG, n=30), the living room lighting was optimized by providing lamps and a basic control system with three preset levels (normal, medium, low). Participants chose the light level and kept a diary. No change was implemented for the control group (CG, n=30). A questionnaire measured self-reported visual and general health and ability to perform ADL in regards to lighting before and after the intervention in both groups. Results: In the IG, lighting levels significantly improved self-assessed lighting levels, abilities to perform ADLs, and read and write in the living room (all p<0.03). In the CG the only change was a deterioration in performing ADLs ( p<0.05). The difference in change was significant between the IG and CG (all p<0.02). "Normal" lighting was the preferred level and increased comfort and well-being. The IG also resumed visually demanding tasks, and acknowledged that avoiding these tasks were mainly due to poor lighting. Conclusions: Good vision is essential in promoting healthy aging at home and require adequate lighting. This can easily be achieved using a basic light system. Adopting to higher lighting levels evolves quickly. Our results suggest that improved quality of light could improve quality of life, and lighting should be included as a factor promoting healthy aging at home.

Reliability of muscle blood flow measurements in orbicularis oculi.

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

Eye-related pain induced by visually demanding computer work.

PURPOSE: Eye strain during visually demanding computer work may include glare and increased squinting. The latter may be related to elevated tension in the orbicularis oculi muscle and development of muscle pain. The aim of the study was to investigate the development of discomfort symptoms in relation to muscle activity and muscle blood flow in the orbicularis oculi muscle during computer work with visual strain. METHODS: A group of healthy young adults with normal vision was randomly selected. Eye-related symptoms were recorded during a 2-h working session on a laptop. The participants were exposed to visual stressors such as glare and small font. Muscle load and blood flow were measured by electromyography and photoplethysmography, respectively. RESULTS: During 2 h of visually demanding computer work, there was a significant increase in the following symptoms: eye-related pain and tiredness, blurred vision, itchiness, gritty eyes, photophobia, dry eyes, and tearing eyes. Muscle load in orbicularis oculi was significantly increased above baseline and stable at 1 to 1.5% maximal voluntary contraction during the working sessions. Orbicularis oculi muscle blood flow increased significantly during the first part of the working sessions before returning to baseline. There were significant positive correlations between eye-related tiredness and orbicularis oculi muscle load and eye-related pain and muscle blood flow. Subjects who developed eye-related pain showed elevated orbicularis oculi muscle blood flow during computer work, but no differences in muscle load, compared with subjects with minimal pain symptoms. CONCLUSIONS: Eyestrain during visually demanding computer work is related to the orbicularis oculi muscle. Muscle pain development during demanding, low-force exercise is associated with increased muscle blood flow, possible secondary to different muscle activity pattern, and/or increased mental stress level in subjects experiencing pain compared with subjects with minimal pain.

Will musculoskeletal and visual stress change when Visual Display Unit (VDU) operators move from small offices to an ergonomically optimized office landscape?

This study investigated the effect of moving from small offices to a landscape environment for 19 Visual Display Unit (VDU) operators at Alcatel Denmark AS. The operators reported significantly improved lighting condition and glare situation. Further, visual discomfort was also significantly reduced on a Visual Analogue Scale (VAS). There was no significant correlation between lighting condition and visual discomfort neither in the small offices nor in the office landscape. However, visual discomfort correlated significantly with glare in small offices i.e. more glare is related to more visual discomfort. This correlation disappeared after the lighting system in the office landscape had been improved. There was also a significant correlation between glare and itching of the eyes as well as blurred vision in the small offices, i.e. more glare more visual symptoms. Experience of pain was found to reduce the subjective assessment of work capacity during VDU tasks. There was a significant correlation between visual discomfort and reduced work capacity in small offices and in the office landscape. When moving from the small offices to the office landscape, there was a significant reduction in headache as well as back pain. No significant changes in pain intensity in the neck, shoulder, forearm, and wrist/hand were observed. The pain levels in different body areas were significantly correlated with subjective assessment of reduced work capacity in small offices and in the office landscape. By careful design and construction of an office landscape with regard to lighting and visual conditions, transfer from small offices may be acceptable from a visual-ergonomic point of view.

Will musculoskeletal, visual and psychosocial stress change for visual display unit (VDU) operators when moving from a single-occupancy office to an office landscape?

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

Musculoskeletal, visual and psychosocial stress in VDU operators after moving to an ergonomically designed office landscape.

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