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Medicina y Seguridad del Trabajo

versión On-line ISSN 1989-7790versión impresa ISSN 0465-546X


MOLINA ARAGONES, Josep Maria et al. Systematic Review of Oculo-Visual and Musculoskeletal Alterations Associated with Visual Display Terminals Work. Med. segur. trab. [online]. 2017, vol.63, n.247, pp.167-205. ISSN 1989-7790.


The changes in the world of work and the introduction of new technologies in recent years have led to an increasing use of visual display terminals (VDT) in many jobs. The discomfort and symptoms experienced during the use of VDT can have a significant impact in terms of quality, -as a result of the increase in the number of mistakes at work-, as well as the economic ones -taking into account the costs derived from temporary incapacity, the loss in working hours or the decrease of productivity-.

The constant evolution in this area implies that the workers’ health surveillance exposed to this risk must be adapted to the knowledge and the most current evidence.


The objective of our review is to structure and analyze the most recent literature on the subject to determine which health effects are associated with the usual use of visual display terminals.


Among November 2015 and January 2016 a bibliographic search was carried out using the keywords combinations «eyestrain», «occupational diseases», «video display terminals», «musculoskeletal diseases», «occupational diseases», «computer» «work» and population surveillance «in the electronic databases PubMed and the Cochrane Library limited to the last ten years. The studied population are individuals exposed to DDS and the results, in terms of health, symptoms or pathologies associated with the use of these technologies. Symptoms, diseases or disorders related to psychosocial risks were excluded of the search. The criteria for the selection of the articles were based on whether the study population had to be fully or partially employed and used computers or data visualization screens and that the health effects had to be in the visual or musculoskeletal sphere, related to working conditions or associated risk factors.

Articles were not initially excluded because of language or type of study. The SIGN criteria (Scottish Intercollegiate Guidelines Network) were used to classify the scientific evidence and to determine the degree of the recommendations.


Results of the initial search were 1711 references, of which, once read the titles and excluded duplicates were reduced to 496. Once read the summaries, 424 other references were excluded considering that the content was not relevant and also for language reasons. Of the remaining 72 articles, 10 were excluded either because the content was irrelevant or did not meet the inclusion criteria, so that finally 62 items were included in the final review.

Workers who usually use DSS regularly have symptoms of work-related discomfort and pain. Currently there are data that suggest the relationship between the use of these equipment and problems at the level of the cervical area. To a lesser extent, it is also associated with symptomatology of the wrist-hand and with vergence and astigmatism at the eye-visual level.


The inclusion of symptomatology in most studies (collected through questionnaires), makes the pathology assessment associated with the use of VDT more complicated. In general it is possible to identify subjective discomfort or symptoms, but it is difficult to translate it into specific pathologies if they are not properly contrasted with objective and well-defined tests. Although there are no strong recommendations for specific interventions in the workplace, a multiple intervention strategy is seen as the most reasonable approach, prioritizing primary and secondary prevention activities, promoting the correct design of workplaces, and acting on training of workers so that they themselves become active subjects of prevention. More studies are required, with longitudinal designs and with a multicentric character to generate more evidence between the association of osteomuscular and oculomotor problems with the labor exposure to VDT.

Palabras clave : Video display terminal; Computer; Asthenopia; Muskuloskeletal diseases; Occupational Health.

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