Background: The work From Home (WFH) employment framework has slowly nestled in everyone’s daily life schedule. The past year witnessed corporate 9 to 5 job employee goes like job-hopping, employees’ demand for flexibility, as well as transparency and workplace safety and further shifting from traditional 9 to 5 job towards the remote work from home. In 2019, 26% of Indian workers were working from home, which increased to about 61% in 2020 and around 53% in 2021. The rise of remote work brought on by the sudden outbreak of the COVID-19 pandemic is quickly becoming the “new normal” which brought into focus some demerits of working from home on a level of subjective experience. Reduced usual ‘time anchors,’ markedly diminished external cues to keep the biological rhythm normal among homebound working groups. However, it is certainly true that most of the corporate sectors are pointing towards promoting the efficient WFH tradition like never before. At the same time, it is very obvious to note that things won’t be the same as they were earlier.

Emerging Health Challenges due to WFH

Implications of the WFH have come with tree main domen of challlages- physiological, psychological, and behavioral , all though these are inter related.

Fig1: Challenges faced by workers (adapted from the study of Majumdar et al., 2020)

1. Physiological challenges: Physiological challenges deal with the dysfunction of live organisms, systems, bodies, and also mechanisms of regulation of bodily functions.

a) Work related Musculoskeletal Disorders (MSD):

Work related Musculoskeletal Disorder (MSD) occurs due to awkward posture, repetitive motions and forces during performing certain tasks. When a Muscle or Tendon, or Joint is stressed and overuse on a repeated basis for prolonged period of time, those body tissues get damaged eventually, which leads to work-related musculoskeletal disorder. Most of the work requires the use of the arms, hands and fingers; so most of the work-related musculoskeletal injuries affect the fingers, hands, wrists, elbows, neck, and shoulders. However, musculoskeletal injuries of the legs, hips, knees, ankles and feet can be occurred where legs are used in work. However, repetitive activities during performing any task may contribute to Spine-related backache.

The work from home policy is a new normal which has switched the work scenario entirely, where a single area is used as domestic space as well as workspace. This home confinement with erratic and prolonged work time from ergonomically unfit workstation can attribute to awkward posture which can lead to somatic pain in certain anatomical sites. Moreover, previous injuries, poor physical condition, erratic lifestyle, and poor diet are the factors that can contribute to MSDs.

Body posture deviating from neutral to twisting neck to view monitor or reaching to use mouse & keyboard due to lack of proper ergonomically designed workstation and also maintaining same working position (prolonged sitting, viewing the monitor with a bent neck or reaching for the keyboard and mouse) for very long time can contribute to wMSDs.

Certain Musculoskeletal disorders like low back pain, Joint pain, Carpal Tunnel syndrome, Epicondylitis, Cumulative Trauma Disorder, or other body parts discomfort have been developed due to the tasks and body movements carried out over and over again during working from home.

Work related musculoskeletal disorders are also associated with high costs to any organization such as absenteeism, loss of productivity, disability, and worker’s compensation costs etc. Musculoskeletal disorder manifestations are more grievous than other nonfatal injury or illness.

Fig 2: Awkward posture during WFH

b) Disruption of Circadian Rhythm:

Circadian rhythm can be described as the physical, mental and behavioral changes in most living organisms over a 24-hour cycle, primarily regulated by the light or darkness of the surrounding environments. It is regulated by the Suprachiasmatic nucleus (SCN) located in the anterior hypothalamus of brain. The Circadian rhythm is endogenous, that is, it is internally controlled and persists even without environmental time cues, though entrained by it. Misalignment of circadian rhythm with external environmental cues or disruption of endogenous control of circadian rhythm results in abnormal or irregular sleep-wake cycles resulting Circadian Rhythm Sleep Disorder (CRSD). Hence, this biorhythm is responsible for regulating sleep/wake cycle throughout each day and night. Periods of increased alertness at other times of the day are also resulted from the circadian rhythm. CRSDs implicate an abnormality in the timing of sleep-wakefulness, which can have serious impact on daily functions of an individual. If untreated, the symptoms of CRSD can develop insomnia, excessive daytime doziness and other psychological and behavioral consequences.

Sudden home isolation and restricted access led to less physical activity and increased e-screen exposure among homebound workers making it trouble to keep their sleep schedule in sync with their circadian rhythm which plays a major role in disturbing their sleep patterns. WFH policy hampered usual bed and rise time of workers due to disturbed or absence of schedule. In addition, lowered availability of natural light, reduced usual ‘time anchor’ markedly diminished external cues to keep them on time and control their sleep/wake cycle and other circadian rhythms; moreover, suppression of melatonin production due to nighttime exposure to bright light is the factors causing sleep deficiency among workers. On this account, the protracted work and work load along with excessive screen exposure to electronic gadgets lead to irregularity in sleep or serious sleep deprivation.

c) Ocular problems:

In current scenario digitalization is advancing at a rapid pace and the use of desktop/laptops, smart phone, e-reader as primary tools at workplaces, academic institutions and homes has become the absolute necessity. The use of these e-gadgets has made our lives much easier and efficient by providing information and communicating with others. However, prolonged use of these e-gadgets associates with its own set of disadvantages. Digital eye strain (Computer vision syndrome) describes a group of eye and vision-related problems that result from excessive screen time exposure from e-gadgets. Another reason for CVS (computer vision syndrome) is the monitor disarrangement – a monitor placed in the wrong position can cause extra ocular pain symptoms like the neck, upper back, and shoulder pain. Excessive e-screen exposure for extended period of time can have a severe ocular consequence of workers.

During the WFH, improper lighting or fluorescent light causing Glare- the difficulty of vision in the presence of bright light such as direct or reflected sunlight or artificial light such, prolonged computer, tablet, e-reader and cell phone use, improper distance between the eyes and the monitor contribute to visual fatigue, double vision, headaches, painful irritation, lacrimation or other ocular problems among home confined corporate workers.

Fig 3: Improper light causing glare during WFH

d) Metabolic Disturbance:

For decades, we have been told that having meals at regular intervals helps to promote our health. Irregular meal timings or poor diet can cause low energy levels, irritability, indigestion, decrease in muscle mass, increase the risk of weight gain and Type 2 diabetes. Fluctuated meal timings cause alteration in blood glucose levels which works against weight management as well as diabetes mellitus.

As employees forced to work from home, exercise and diet are both on the wane. The development of the metabolic disorder is partly due to their sedentary lifestyle and reduced physical activity. Moreover, prolonged period of work with same posture and no exercise is traditionally associated with irregular eating habit, which can promote different gastro intestinal comorbidities like indigestion, obesity etc.

2. Psychological Consequences:

When employees work from home, divertissement make it all too easy to get sidetracked. Household duties and family responsibilities have one of the biggest potentials to reduce workers’ focus, alertness while other people are wooed by social media applications. Smart phone, desktop and others electronic devices might be essential tool for work; but sudden home isolation along with this excessive screen exposure, lack of sleep also affects an individual’s mental health bringing on inattention with boredom, tension, irritability, fatigue, anxiety, and depression. This unusual home isolation, plus anxiety and stress due to domestic dissension may contribute to this increase in the symptoms of depression among home bound workers.

3. Behavioral Consequences:

Loneliness, monotony and moreover lack of motivation can become a serious challenge when this working from home longterm. Additionally, lack of interaction with colleagues can lead to dissatisfaction among workers. According to the theory of BIS (Behavioral inhibition system), it is found that when social uncertainty increased, such as unknown etiology and ambiguous route of transmission, people developed the negative cognitive behaviorand moreover, social isolation can trigger some behavioral changes such as irregularity, heavy smoking and impulsive emotional behavior.

4. Poor time management: Time tracking is quite a big challenge for home bound remote workers as they often lose the sense of time which is can reduce their productivity or lead to excessive screen exposure.

Cope up strategies from Ergonomic perspective

Some simple coping behaviors based on an Ergonomic point of view can protect this homebound working population against the physiological as well as mental consequences prevalent to this new normal life.

Postscript:

a) Workstation arrangement: Setting up an ergonomically correct workspace at home will protect you from the physical health challenges of WFH. A suitable area for setting up the workspace with limited external noise and distraction is necessary by assuring that it is a devoted workspace.

Body must be in “Neutral” posture! (90-90-90 posture).

Fig 4: "Neutral" posture! (90-90-90 posture)

Fig 5: Properly organized equipment for home workstation

b) Glare minimization: To eliminate all sources of glare the monitor should be positioned parallel to windows and overhead lights. Usage of anti-glare screen on computer or making use of curtains or blinds to control the natural light can minimize the glare.

c) 20-20-20 Rule: This eye break rule (in every 20minutes looking 20 feet away for 20 seconds) is beneficial to avoid eye strain.

d) Multiple brief breaks with getting up and moving around in every 20-30minutes or Power nap can be useful.

e) Performing some Stretching exercises or Yoga can be highly beneficial for both sleep and alertness as it offers the capability to reset body and mind to a state of homeostasis.

f) Meditation improves concentration and reduces mental stress and taking small portion of sleeps whenever possible is one of the most obvious countermeasures of sleep loss and sleep deprivation

g) Taking a set Coffee and lunch breaks, munching on healthy snacks like fruit, nuts, seeds and drinking plenty of water will be beneficent for the health.

Epilogue:

With the multitudinous uncertainties surrounding the global COVID-19 pandemic, corporate workers had to switch their working styles. This worldwide lockdown had become a chance to look within. While many of us had to enduresome drastic repercussion of this sudden transpose. However, adapting to this new working pattern is the solution to keep going. Thus, here is a need to increase awareness through various ways and ensure that people are highly complying with the preventive measures as well as palliative measures to reduce the radical impacts of the pandemic.

About the author:

Dr. Subhashis Sahu, presently working as Head of the Department of Physiology, University of Kalyani. He serves both Academia and Industry as Educator and Consultant in the field of Ergonomics and Occupational Physiology. He is an active researcher and publish more than 100 research papers, book chapters in National and International Journals in the field of Occupational Health and Safety. Apart from serving the University of Kalyani as Faculty, he acts as Visiting Faculty in NID, RLI, University of Calcutta etc. He is also a Vision Zero Trainer and Consultant in Ergonomics.

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Subhashis Sahu, M.Sc., Ph.D., FABMS
Ergonomics & Occupational Physiology Laboratory,
Department of Physiology
University of Kalyani
Email :skcsahu@yahoo.co.in/ssahu@klyuniv.ac.in