2021 Volume 8 Issue 2

Visual Display Terminals Health Impact During COVID 19 Pandemic on the Population in Jeddah, Saudi Arabia


Fathi El-Gamal, Fedaa Najm, Nedaa Najm, Jumanah Aljeddawi
Abstract

Working with visual display terminals (VDT) is growing significantly in the global information age, with the vast growth of digital devices, which is also followed by a higher incidence of health issues. To explore the physical and mental health impacts of long term use of visual display terminals on the population in Jeddah, Saudi Arabia. It was a cross sectional study; the method of non-probability convenient sampling was used to collect data on 503 subjects, in Jeddah city through online-Google forms. Data collection was done through the use of a predesigned questionnaire that provided information on individual, socio-demographic, and clinical features of the subjects as well as information on the aspects of use of VDT. Statistical analysis: data analysis was performed in  SPSS version 23. The sample size was 503 subjects with mean age of 31.95 ±12.51 years, 98% of them used VDTs. They used it almost every day (mean= 6.6 ± 1 days), for about 8 hours per day (mean= 8.2± 4.1 hours). Students and office employees used the VDT > 7 hours/day. Almost, all the subjects (99%) used smart phones. Headache, neck pain and shoulder pain, lower back pain, dryness of the eye and interrupted sleep were common complaints among VDT users. It also, interfered with their daily life activities. In principal component factor analysis, duration of use of VDT in hours/day (weight = 0.710), and days/week (weight = 0.724) were significantly loaded on one factor; however, no other variables had weight greater than 0.3 on this factor.


How to cite this article
Vancouver
El-Gamal F, Najm F, Najm N, Aljeddawi J. Visual Display Terminals Health Impact During COVID 19 Pandemic on the Population in Jeddah, Saudi Arabia. Entomol Appl Sci Lett. 2021;8(2):91-9. https://doi.org/10.51847/jJp0wj6I4S
APA
El-Gamal, F., Najm, F., Najm, N., & Aljeddawi, J. (2021). Visual Display Terminals Health Impact During COVID 19 Pandemic on the Population in Jeddah, Saudi Arabia. Entomology and Applied Science Letters, 8(2),91-99. https://doi.org/10.51847/jJp0wj6I4S

Visual Display Terminals Health Impact During COVID 19 Pandemic on the Population in Jeddah, Saudi Arabia

 

Fathi El-Gamal1*, Fedaa Najm2, Nedaa Najm2, Jumanah Aljeddawi2

 

1Department of Family Medicine, Ibn Sina National College for Medical Studies, Jeddah, KSA.

2Ibn Sina National College for Medical Studies, Jeddah, KSA.


ABSTRACT

Working with visual display terminals (VDT) is growing significantly in the global information age, with the vast growth of digital devices, which is also followed by a higher incidence of health issues. To explore the physical and mental health impacts of long term use of visual display terminals on the population in Jeddah, Saudi Arabia. It was a cross sectional study; the method of non-probability convenient sampling was used to collect data on 503 subjects, in Jeddah city through online-Google forms. Data collection was done through the use of a predesigned questionnaire that provided information on individual, socio-demographic, and clinical features of the subjects as well as information on the aspects of use of VDT. Statistical analysis: data analysis was performed in  SPSS version 23. The sample size was 503 subjects with mean age of 31.95 ±12.51 years, 98% of them used VDTs. They used it almost every day (mean= 6.6 ± 1 days), for about 8 hours per day (mean= 8.2± 4.1 hours). Students and office employees used the VDT > 7 hours/day. Almost, all the subjects (99%) used smart phones. Headache, neck pain and shoulder pain, lower back pain, dryness of the eye and interrupted sleep were common complaints among VDT users. It also, interfered with their daily life activities. In principal component factor analysis, duration of use of VDT in hours/day (weight = 0.710), and days/week (weight = 0.724) were significantly loaded on one factor; however, no other variables had weight greater than 0.3 on this factor.

Keywords: VDT, Jeddah, Health effects, COVID-19 pandemic.


INTRODUCTION

 

During COVID-19 pandemic, the use of video display terminals (VDT) obviously increased. It had its significant impact on general health as many researches show [1-4]. Females tended more to use smart phones, while males more frequently used laptops, desktops, as well as, handheld, (non-) active game consoles the use of smartphones dominated the rest [1, 5].

The neck/shoulder region initially reported Musculoskeletal symptoms later on also the upper and lower back, arms, wrist and hand [2].

The majority daily VDT use time of most of the partakers 6–11 hours [3, 4, 6, 7]. There is an increase in incidences of dry eye because of the extreme expansion in internet networks and its mediated communications. 36% of respondents to an internet-based self- screening questionnaire reported dry eye symptoms [8]. In the Commonwealth of Massachusetts, the effects of headaches and musculoskeletal discomfort were higher among VDT workers in public utilities, computer and data processing services than in banking, communications, and hospitals. Less frequent symptoms were double vision and coloured halos around objects, with prevalence below [9]. There is a range of 12.1% to 71.5% in the year-long prevalence of neck pain in grown-ups. The increased Frequency of neck disorder, upper and lower back extremity has been linked to the heightened us of VDT [10-12]. Lower back pain being the chief hinderance in VDT workers. The significant increase in proportion of partakers testifying about physical discomfort from backache to ocular soreness can be attributed to the higher number of VDT work hours [13-15]. An age and gender adjustment in the multivariate models showed a prevalence of wrist/hand symptoms with prolonged screen time [16]. A primarily localization of the dermatological conditions show that repetitive friction and trauma causes the majority of palm and finger problems as well as allergic contact sensitivities [17]. The worsening of depressive and anxiety states form the main mental health effects. Collectively referring to the symptoms as VDT syndrome. A sharp increase in the syndrome is attributed to longer VDT work hours i.e., exceeding five hours [18]. Prolonged use of VDT was associated, also, with insomnia, irritability, weariness, sleep disturbances and psycho-physical troubles [19, 20].

A study in Japan confirmed that an excess of 5hours in VDT attributed to a degradation in mental health in its administrative staff [21]. Additionally, poor self-rated health was linked to a 3 hour plus use of VDT according to a national study of Saudi adults [22]. An exploration of the magnitude and frequency of VDT use during the COVID-19 pandemic, and occurrence of self-reported health complaints among the population of Jeddah, Saudi Arabia was the main aim of the study.

MATERIALS AND METHODS

The method of non-probability convenient sampling was used to collect data for the cross sectional study, on the population through web based online-Google forms. The minimal sample size required for the present study was calculated to be 220 subjects, using G*Power software, according to alpha = 0.05, and Power= 95%, and 5 degrees of freedom [23]. The total number of subjects enrolled in the present study was 503 respondents. collection of data was done by a predesigned questionnaire which provided information on individual, sociodemographic, and clinical features of the subjects; in addition to information on the duration and frequency of use of VDT, as well as the purpose and way of using it. Approval of the design of the study was granted by the Institutional Review Board of the Ibnsina National College for medical studies (No. H-11-09062021).

Statistical analysis: SPSS version 22 was used. Chi square test of significance and principal component factor analysis were used and weights for loading on the variables were calculated. Loadings equal or greater than 0.5 were considered significantly associated with the extracted factor. All variables that significantly loaded on a factor are significantly associated with each other. Level of significance for the present study was 0.05.

RESULTS AND DISCUSSION

The total number for the present study was 503; with a mean of 31.95 years (SD: 12.51). Quite a number of subjects (97.6%) used video display terminals (VDT). The mean use per days of the week was 6.6 days (SD: 1), and the mean hour use of VDT per day was 8.2 (SD: 4.1).

Table 1 shows the distribution of the studied subjects by duration of use of VDT and personal characteristics and self-reported morbidity conditions. Majority of the subjects who used VDT were females (82.3%), and bachelor holders (69.2%); however, they were no significantly related to number per hour use per day (p>0.05). Students and those who have office jobs used the VDT more than 7 hours per day (38.4%, and 30.3% respectively) more than less than 7 hours per day (24.3%, and 25.2%), this difference was statistically significant (p < 0.000). Smoking was irrelevant to use of VDT (p <0.502). Diabetes mellitus was significantly more encountered among those who used VDT less than 7 hours per day compared to those who used VDT over 7 hours per day (11.2%, and 5.7% respectively), where p < 0.027. Joint diseases showed similar trend (p < 0.002). Hypertension, heart disease, visual disturbance and allergies were irrelevant to duration of use of VDT per day (p >0.05). Table 2 displays the distribution of studied subjects by duration of use of VDT per day and characteristics of use of VDT device. Majority of the subjects used smart phones (98.6%), laptops (69.1%), and tablet devices (50.5%).1%); lease percentage used desktop computers (32.1%). The duration of use per day was irrelevant to the VDT device used (p > 0.05). The purpose of use of the device was for study, entertainment and/or work; it was irrelevant to the duration of use per day (p <0.136). Majority of the subjects used the VDT 7 days per week (83.7%); however in was higher among those who used VDT over 7 hours per day (89.2%) compared to those who used the VDT less than 7 hours per day (75.7%), where p <0.002. Majority of the subjects spend time using VDT while sitting on couches (45.8%); those who use VDT over 7 hours per day tended to use desks and bed while using the devices (20.9%, and 38.7% respectively), more commonly compared to those who used DVT devices for less than 7 hours per day (15.6%, and 30.7% respectively), this difference were statistically significant (p <0.013). Table 3 reveals hours of use of VDT per day and self-reported complaints. Headache (76.5%) was the most prevalent complaint among VDT users, followed by neck pain and shoulder pain and lower back pain (59.2%, 55.9%, and 45.7% respectively). Dryness of the eye was next in frequency (52.9%). Double vision and numbness of the fingers were reported by over one third of the VDT users (32.8%, and 37.3% respectively). All these complaints were irrelevant of duration of use of VDTs per day (p > 0.05). Table 4 depicts the association between hours of use of VDTs per day and life style changes.  Mood swings (60.0%), and interrupted sleep (56.5%) were main complaints reported by the VDT users, however they were irrelevant to duration of exposure to VDT per day (p > 0.05).  Large proportion of the VDT users (44.5%) reported that using VDTs interfered with their daily life activities; and had difficulty falling asleep (44.1%); these complaints were irrelevant to the duration of use VDT per day (p > 0.05). A sizable proportion of the subjects (43.1%) reported that they got depressed, if the VDT hadn’t been available; this was significantly more common among those who use the VDT > 7 hours per day (48.5%) compared to those who use VDT < 7 hours per day (35.4%), where p < 0.004. Table 5 shows the principal component factor analysis for the VDT use characteristics and other personal and clinical variables. The variables use of DVT in hours per day (weight= 0.710), and use of VDT in days per week (weight=0.724) were significantly associated with factor 8; no other variable had weight greater than 0.5 on this factor.

It has long been established that poor self-rated health and severe psychological distress was linked to a 10 hour plus use of VDT for work [21, 22, 24]. Additionally, a 4–9 h usage of VDT especially during the Covid-19 pandemic, was linked to extreme psychological distress among young staff. However as for non-work activities, VDT did not have the extreme effects in both physical and mental health [25]. This study was done to explore the link between self-reported psychological and health distress and VDT usage among the general population, in Saudi Arabia during the COVID-19 pandemic. Smartphone use dominated with a higher usage in girls than boys, whilst in boys there was a much higher use of laptops, desktops, in addition to, handheld, (non) active game consoles. Laptop use increase with increasing school level [1]. Similar findings were found in the present study. Smartphone use dominated multiple activities: homework, videos, games and general use among the devices [26]. Social activity, like messaging and social media, was used the most in the smartphone, whilst tablet use was mainly watching videos, desktop and laptop [6]. In the present study, the purpose of use of the VDT was for study, entertainment and/or work; it was irrelevant to the duration of use per day (p <0.136). Headache (76.5%) was the most prevalent complaint among VDT users, followed by neck pain and shoulder pain and lower back pain (59.2%, 55.9%, and 45.7% respectively).  This is similar to previous studies [4, 18, 20] which stated that an increased prevalence of neck disorders, upper and lower back of the body was attributed to a higher use of Visual Display Terminal (VDT). There is an increase in incidences of dry eye because of the extreme expansion in internet networks and its mediated communications. 36% of respondents to a web-based self- screening questionnaire reported dry eye symptoms [8]. This is in line with the present study which found that over 50% of the VDT users suffered from dry eye disease.

 

 

Table 1. Distribution of studied subjects by duration of use of VDT and personal characteristics and morbidity history.

Variable

Categories

Time of use of VDT per day

Total

X2

(p- value)

< 7 hours

≥ 7 hours

     N              %

      N           %

      N           %

Gender

Female

176       85.9%

237       97,8%

413          82,3%

3.049

(0.081)

Male

29         14,1%

60         20,2%

89           17,7%

Education

bachelor or higher

141       68.4%

207       69.7%

348          69.2%

0.089

(0.765)

less than bachelor

65         31.6%

90         30.3%

155          30.8%

Job

No job

86         41.7%

75         25.3%

161          32.0%

20.091

(0.000)

Student

50         24.3%

114       38.4%

164          32.6%

Hand worker

18           8.7%

18           6.1%

36              7.2%

Office job

52         25.2%

90         30.3%

142          28.2%

Smoking

Non smoker

182        88.3%

256        86.2%

438           87.1%

0.502

(0.479)

Smoker

24          11.7%

41          13.8%

65             12.9%

Diabetes

No

183        88.8%

280        94.3%

463           92.0%

4.920

(0.027)

Yes

23          11.2%

17            5.7%

40               8.0%

hypertension

No

188        91.3%

274        92.3%

462           91.8%

0.160

(0.689)

Yes

18            8.7%

23            7.7%

41               8.2%

Heart disease

No

202        98.1%

290        97.6%

492           97.8%

0.098

(0.754)

Yes

4              1.9%

7              2.4%

11               2.2%

Joint disease

No

178        86.4%

280        94.3%

458           91.1%

9.224

(0.002)

Yes

28          13.6%

17            5.7%

45               8.9%

Visual impairment

No

122        59.8%

170        58.0%

292           58.8%

0.158

(0.691)

Yes

82          40.2%

123        42.0%

205           41.2%

Allergies

No

115        55.8%

173        58.6%

288           57.5%

5.031

(0.282)

Chest

20            9.7%

21            7.1%

41               8.2%

Rhinitis

35          17.0%

21            7.1%

100           20.0%

Eye

8              3.9%

8              2.7%

16               3.2%

Skin

28          13.6%

28            9.5%

56             11.2%

 

Table 2. Distribution of studied subjects by duration of use of VDT and characteristics of use of VDT device.

Variable

Categories

Time of use of VDT per day

Total

X2

(p- value)

< 7 hours

≥ 7 hours

N        %

N       %

N      %

use a smart phone

No

1       0.5%

6       2.0%

7       1.4%

2.088

(0.148)

Yes

205   99.5%

291   98.0%

496   98.6%

use a tablet device

No

103   50.0%

146   49.2%

249  249.5%

0.034

(0.854)

Yes

103   50.0%

151   50.8%

254   50.5%

Use a laptop

No

66    32.0%

89    30.1%

155   30.9%

0.221

(0.638)

Yes

140   68.0%

207   69.9%

347   69.1%

Use a desktop computer

No

145   70.4%

196   66.2%

341   67.9%

0.971

(0.325)

Yes

61    29.6%

100   33.8%

161   32.1%

Purpose of use*

S

11     5.3%

9      3.0%

20     4.0%

9.744

(0.136)

W

39     18.9%

41    13.8%

80      15.9%

E

41     19.9%

48    16.2%

89      17.7%

S,W

7         3.4%

14      4.7%

21        4.2%

W,E

22     10.7%

40    13.5%

62      12.3%

S,E

51     24.8%

70    23.6%

121   24.1%

S,W,E

35     17.0%

75    25.3%

110    21.9%

Number of days per week using devices

1

3         1.5%

1     0.3%

4          0.8%

20.762

(0.002)

2

2         1.0%

2     0.7%

4          0.8%

3

5         2.4%

2     0.7%

7          1.4%

4

1         0.5%

1     0.3%

2          0.4%

5

31     15.0%

15    5.1%

46        9.1%

6

8         3.9%

11    3.7%

19        3.8%

7

156   75.7%

265   89.2%

421    83.7%

Way of spending time on VDT

On desk

32     15.6%

62   20.9%

94      18.7%

8.630

(0.013)

On couch

110   53.7%

120   40.4%

230    45.8%

On bed

63     30.7%

115   38.7%

178    35.5%

*S:study ; W:worke ; E:entertainment.

 

Table 3. Distribution of studied subjects by duration of use of VDT and occurrence of health problems.

Variable

categories

Time of use of VDT per day

Total

X2

(p- value)

< 7 hours

≥ 7 hours

     N            %

       N              %

       N            %

Eye dryness

No

97           47.1%

140        47.1%

237        47.1%

0.00

(0.991)

Yes

109         52.9%

157        52.9%

266        52.9%

Headache

No

52           25.2%

66          22.2%

118        23.5%

0.618

(0.432)

Yes

154         74.8%

231        77.8%

385        76.5%

Double vision

No

139         67.5%

199        67.0%

338        67.2%

0.012

(0.912)

Yes

67           32.5%

98          33.0%

165        32.8%

Neck pain

No

84           40.8%

121         40.7%

205         40.8%

0.00

(0.994)

Yes

122         59.2%

176         59.3%

298         59.2%

Shoulder pain

No

92           44.7%

130         43.8%

222         44.1%

0.039

(0.843)

Yes

114         55.3%

167         56.2%

281         55.9%

Lower or upper back pain

Upper

49           23.8%

57           19.2%

106         21.1%

3.613

(0.164)

Lower

84           40.8%

146         49.2%

230         45.7%

No

73           35.4%

94           31.6%

167         33.2%

Wrist pain

No

149         72.3%

226         76.1%

375         74.6%

0.908

(0.341)

Yes

57           27.7%

71           23.9%

128         25.4%

Hands joint pain

No

142         68.9%

228         76.8%

370         73.6%

3.840

(0.050)

Yes

64           31.1%

69           23.2%

133         26.4%

Hands muscle weakness

No

163         79.1%

244         82.2%

407         80.9%

0.722

(0.395)

Yes

43           20.9%

53           17.8%

96           19.1%

Fingertips numbness

No

124         60.2%

190         64.0%

314         62.4%

2.073

(0.355)

Yes

81           39.3%

107      36.0%

188      37.4%

Hands shivering

No

172         83.5%

239         80.5%

411        81.7%

0.744

(0.388)

Yes

34           16.5%

58           19.5%

92           18.3%

Dry hands

No

163         79.1%

233         78.5%

396         78.7%

0.033

(0.856)

Yes

43           20.9%

64           21.5%

107         21.3%

Itchiness hands

No

165         80.1%

258         86.9%

423         84.1%

4.170

(0.041)

Yes

41           19.9%

39           13.1%

80           15.9%

Recurrent skin inflammation

No

177         85.9%

262         88.2%

439         87.3%

0.576

(0.448)

Yes

29           14.1%

35           11.8%

64           12.7%

 

Table 4. Distribution of studied subjects by duration of use of VDT and life style and psychological state.

Variable

categories

Time of use of VDT per day

Total

X2

(p- value)

< 7 hours

≥ 7 hours

    N             %

       N              %

               %

Interference with daily life activity

No

115         55.8%

164       55.2%

279        55.5%

0.018

(0.893)

Yes

91           44.2%

133       44.8%

224        44.5%

Depressed if  VDT is not available

No

133         64.6%

153       51.5%

286        56.9%

8.442

(0.004)

Yes

73           35.4%

144       48.5%

217        43.1%

Mood swings

No

87           42.2%

114      38.4%

201         40.0%

0.751

(0.386)

Yes

119         57.8%

183      61.6%

302         60.0%

Difficulty falling asleep

No

115         55.8%

166      55.9%

281         55.9%

0.00

(0.988)

Yes

91           44.2%

131      44.1%

222         44.1%

Interrupted sleep

No

90           43.7%

129      43.4%

219         43.5%

0.003

(0.955)

Yes

116         56.3%

168      56.6%

284         56.5%

Table 5. Principal component factor analysis with Vari Max rotation of the use of VDT and personal, social, morbidity history

Rotated Component Matrix

Variables

Component

1

2

3

4

5

6

7

8

Sex

-.041

.087

-.817

.006

.043

.065

.043

-.070

Age

.634

-.062

.285

-.160

-.139

.128

-.139

-.293

Smoking

-.088

.094

.776

-.080

.155

-.006

-.003

.047

Diabetes Mellitus

.477

-.113

.387

.054

-.298

.152

.224

-.062

Hypertension

.373

.025

.323

.145

-.425

.296

.027

-.146

Use of VDT hours/day

-.047

.039

.051

.113

.075

-.108

.196

.710

Use of VDT days/weeks

.032

-.053

.047

.049

-.121

.095

-.225

.724

Eye dryness

.302

.178

-.099

.142

.271

.196

.071

.059

Headache

-.207

.501

-.234

.083

.149

.202

.118

.114

Double vision

.170

.235

-.043

.107

.260

.135

.398

-.061

Neck pain

.137

.721

.085

.137

.063

.196

.094

.004

Shoulder pain

.240

.748

.011

.059

.067

.042

.037

-.058

Lower/ upper back pain

-.115

-.688

-.001

-.025

-.055

.124

-.062

.010

Wrist pain

.702

.228

-.107

.015

.115

.014

-.070

.039

Hands joint pain

.699

.172

-.047

.045

.113

.048

.089

.048

weakness in hand muscles

.585

.165

.010

-.138

.196

.200

.305

.104

Numbness in fingertips

.424

-.043

-.002

.315

.068

-.059

.328

-.136

Tremors

-.040

.179

.042

.112

-.130

.027

.756

.001

Dry rough hands

.236

-.044

-.102

-.109

.291

.243

.515

.071

Hand itchiness

.186

.042

.050

.113

.073

.748

.111

-.071

recurrent skin inflammations

.037

.094

-.078

-.035

.056

.799

.060

.041

VDT interferes with  daily life activities

.077

.113

-.145

.573

.187

-.043

-.095

.031

Depressed/ anxious if VDT are not available

.026

.006

.049

.741

.048

.024

.069

.194

Mood swings

-.142

.170

.003

.656

.197

.148

.170

-.033

Difficulty falling asleep

.084

.092

.035

.275

.663

.047

.071

-.035

Interrupted sleep

.149

.148

.133

.230

.675

.127

.027

-.054

 

 

Double vision and numbness of the fingers were reported by over one third of the VDT users (32.8%, and 37.3% respectively). This is consistent with findings from previous study [10, 17]. The worsening of anxiety and depressive states have been reported as mental health effects.  Prolonged VDT work is associated with insomnia, irritability, weariness, psycho-physical troubles [18-20]. In the present study mood swings (60.0%), and interrupted sleep (56.5%) were main complaints reported by the VDT users. Large proportion of the VDT users (44.5%) reported that using VDTs interfered with their daily life activities; and had difficulty falling asleep (44.1%). In the recent years there has been a rapid increase in smartphone use. This may result in the convergence of internet addiction and mobile phone problems into smartphone addiction [26]. In the present study a 43.1% reported that they got depressed, if the VDT hadn’t been available; this was significantly more common among those who use the VDT > 7 hours per day. Principal component factor analysis revealed that all physical and psychological manifestations were irrelevant of the duration of usage of VDT regarding hours per day or days per week.

Limitations

Some limitations to this study are: firstly, there is a subjective measurement of the use of VDT that might not represent the existent use. However, a closed estimate of actual use was employed by asking the partakers the total hours of VDT usage per day. Secondly, due to the cross-sectional nature of the study, it is not possible to deduce if the effects of the use of VDT in the COVID-19 pandemic will have a persevere in the long run. In order to look into the long-term health effects of non-pharmacological measures during the COVID-19 pandemic, further studies are required.

CONCLUSION

Almost, all the subjects (99%) used smartphones. Headache, neck pain and shoulder pain and lower back pain, and dryness of the eye, mood swings and interrupted sleep were common complaints among VDT users. It also, interfered with their daily life activities. In principal component factor analysis use of DVT in hours per day (weight= 0.710), and days per week (weight=0.724) were significantly loaded on one factor; however, no other variables had weight greater than 0.5 on this factor. Prolonged use of VDT may lead to VDT addiction. A recommendation of more study on the links between health and purpose- specific VDT usage.

ACKNOWLEDGMENTS: We thank all the participants for their cooperation throughout the study.

CONFLICT OF INTEREST: None

FINANCIAL SUPPORT: None

ETHICS STATEMENT: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Ibnsina National College for medical studies (No. H-11-09062021, approval date: 9 – 6- 2021).


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