Imaging Ergonomics: The Perfect Setup
By Keith Loria
Radiology Today
Vol. 22 No. 2 P. 6

An ergonomic home reading room need not be a pain in the neck.

With radiologists spending so much of their day in front of a computer workstation reporting out cases, often with few breaks, it follows that an ergonomically sound reading environment is an absolute must. This issue has become even more important over the past year, as many radiologists were forced to work from home due to the COVID-19 pandemic and needed to set up reading rooms in places not usually designed for a full-time workstation.

“Setting up an ergonomic reading room is actually quite simple but requires a bit of planning,” says Mike Kelleher, MD, a radiologist and the medical director for Nines Radiology, based in Palo Alto, California. “When planned thoughtfully, radiologists will be able to maximize their quality and productivity, optimizing one’s longevity and ability to provide the best possible care for our patients.”

Kelleher notes radiologists should always start by choosing a high-quality desk that can be easily adjusted to allow for sitting or standing. The ability to stand while at work, as well as having a chair with adequate back and neck support, helps to reduce back pain. He recommends an adjustable chair with excellent lumbar and neck support.

Michael Esposito, MD, president and founder of PACS Harmony and Dextro Imaging Solutions, says two of the biggest complaints radiologists have about home reading rooms are about their desk height and chair.

“As a rule of thumb, the center of the monitors should be at eye level when you are sitting up straight,” Esposito says. “A good desk chair could cost over $1,000 but is worth the money. You will spend eight to 10 hours a shift in the chair, and it is key to avoid back pain or neck pain.”

In addition, radiologists often need to miss work or even have surgery due to overuse injuries of the wrist, including carpal tunnel syndrome, so using a proper keyboard and mouse minimizes this risk.

“Keyboard and mouse selection are critical and must allow for a neutral wrist position,” Kelleher says.

Other Important Considerations
An improper reading room setup can impact job satisfaction. Eliot Siegel, MD, a professor and vice chair at the University of Maryland School of Medicine in the department of diagnostic radiology and chief of radiology and nuclear medicine for the VA Maryland Healthcare System, says the key to avoiding any issues is finding a comfortable space where one can control sound, lighting, and ventilation, along with a supportive chair and desk set at the right height and bright, high-resolution monitors as well as a high-quality keyboard and mouse.

“The most important overlooked consideration is sound, which can be a problem in most homes,” Siegel says. “A sound masking system is a great investment, if background sounds of family members and other noises represent distractions.”

Esposito notes that images are now read on a computer monitor and glare can be an issue. As glare usually comes from sunlight, this can be blocked using shades.

“The ability to dim the overhead lights is very helpful,” he adds.

Siegel says lighting should come from LED bulbs on a dimmer switch, and desk lamps should also have a dimmer switch for task lighting. And don’t skimp on the monitor. Siegel adds that this is something that should be as high quality as possible.

“The cost of 32-inch, high-resolution monitors has come down considerably, and I would look for ones that have a luminance of at least 350 cd/m2,” he says. “Background lighting levels should match monitor brightness and, with higher brightness monitors, background light can be relatively higher, without the need to read in relative darkness.”

Setting monitor heights to the correct level and ensuring proper lighting reduces fatigue and eye strain. These are critical in ensuring a high level of productivity and quality.

“The radiologist should be looking down at the monitors with the eyes at or above the upper level of the monitor, if possible, to minimize neck strain,” Siegel says.

Additionally, a mechanical keyboard can be relatively inexpensive and is a solid investment, as is a higher-quality mouse. A speakerphone should be within easy reach; the chair should have good lumbar support and, ideally, adjustable armrests.

“Investing in a high-quality setup like this should pay for itself in a matter of two to three months or less and can avoid major issues such as neck strain, eye strain, and carpal and cubital tunnel syndromes,” Siegel says. “Good airflow and optimal temperature control are also important.”

An Ounce of Prevention
Improper ergonomics can reduce productivity, increase mental strain and stress, and decrease accuracy in diagnosis. Additionally, eye strain, neck pain, myopization—temporary nearsightedness—back pain, and repetitive motion disorders can all be caused by a home reading room that is not set up correctly.

For example, mismatches between monitor and room brightness will cause eye strain and fatigue, as will flicker from fluorescent lights and nonergonomic desks, chairs, and monitors. Temperature extremes can also result in fatigue, as can distracting background noises.

Back problems and other muscle issues are common in most radiologists, and Siegel says one way to combat this is to have stand up/sit down workstations with desks that elevate so radiologists can spend part of the day standing and part of the day sitting. 

“Repetitive motion disorders, such as carpal and cubital tunnel syndromes, have been reported in the radiology literature,” he says. “Higher-end mouse and keyboards can decrease this. Pausing to get up and stretch can make a big difference, as can the 20/20/20 rule for eyestrain, which says that looking 20 feet away for 20 seconds every 20 minutes is helpful. Healthy diet and exercise will also help minimize back strain, neck strain, and muscular strain in general.”

Remember, it is much easier to set up a room correctly the first time than to modify an existing room that was not set up optimally, but either is well worth the investment.

Keith Loria is a freelance writer based in Oakton, Virginia. He is a frequent contributor to Radiology Today.