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DOI:10.3233/WOR-205294
IOS Press
1
An assessment of ergonomic issues in the
home offices of university employees sent
home due to the COVID-19 pandemic
1
2
3
Thomas Gerdinga,∗, Megan Sycka, Denise Danielb, Jennifer Naylorb, Susan E Kotowskic,
Gordon L. Gillespieb, Andrew M. Freemana, Thomas R. Hustondand Kermit G. Davisa
4
5
aDepartment of Environmental and Public Health Science, College of Medicine, University of Cincinnati, USA6
bCollege of Nursing, University of Cincinnati, USA7
cDepartment of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences,
University of Cincinnati, USA
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dDepartment of Mechanical Engineering, College of Engineering and Applied Sciences, University of Cincinnati,
USA
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Received 5 December 2020
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Accepted 27 January 2021
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Abstract.14
BACKGROUND: As millions of workers have shifted to telework, special accommodations for workers with respect to
ergonomics may be required to ensure the workforce remains healthy.
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METHODS: A survey about home office ergonomics and discomfort was sent to faculty, staff, and administrators by email
and was completed by 843 individuals.
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RESULTS: Over 40% of the participants reported moderate to severe discomfort (severe low/middle back pain, moderate
discomfort in eyes/neck/head, and discomfort in the upper back/shoulders). Laptops (always and often) were widely used
(85%) with most using the laptop monitor (55%) of all respondents. Further, less than 45% of the seating conditions were
reported as having adjustable arm rests.
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CONCLUSION: As teleworking in makeshift offices becomes more common, the risk of significant discomfort and poten-
tially more serious musculoskeletal disorders may result from poor static postures. Companies may need to accommodate
workers by allowing them to take home office chairs, external monitors, keyboards, and mice as laptops are insufficient,
ergonomically.
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Keywords: Telework, musculoskeletal disorder, human-computer interface27
1. Introduction28
According to the United States (U.S.) Census Bur-29
eau, there were over 128 million full-time employees
30
in the U.S. in 2019, with some employees working
31
from home [1]. The U.S. Bureau of Labor Statistics
32
states the number of people working a portion or all
∗Address for correspondence: Thomas Gerding, Kettering Lab-
oratory Room 133, 160 Panzeca Way, Cincinnati, Ohio 45267,
USA. E-mail: gerdintr@mail.uc.edu.
their hours from home increased from 19% in 2003 33
to 24% in 2015 [2]. While many occupations (e.g., 34
manufacturing, construction, warehousing) were less 35
likely to work from home, 38% of management, bus- 36
iness, and financial operations and 35% of professio- 37
nal workers worked at least partially remote. Remote 38
work, work from home, virtual work, or telecommu- 39
ting (hereafter referred to as telework), which was 40
developed in the 1970s, involves different work 41
strategies using information and communication 42
technologies such as desktop computers, laptops, 43
ISSN 1051-9815/$35.00 © 2020 – IOS Press and the authors. All rights reserved
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2T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic
tablets, or smartphones for work that is completed44
outside the employer’s buildings [3]. Telework has
45
traditionally allowed workers to save time and money46
otherwise spent on commuting, but in the current env-47
ironment, its value is also reducing the risks regard-48
ing employees gathering at work during the ongoing
49
pandemic.50
The spread of the novel coronavirus (COVID-19)51
was classified as a global pandemic by the World52
Health Organization on March 11, 2020 [4]. Follo-
53
wing this, the United States declared health emer-54
gencies at the federal and state level, with every state55
individually declaring an emergency associated with
56
the stay-at-home quarantine policy. These policies57
caused many U.S. workers to transition to work in a
58
home office abruptly. Telework was thrust upon mil-59
lions of people, some estimates of more than 55% of60
the U.S. workforce will work at home during the next
61
two years [5].62
Telework has been studied since the turn of the63
century, with findings ranging from both beneficial64
and detrimental outcomes [6, 7] In a survey of IBM65
employees who provided self-assessment of their66
subjective performance, those working in a virtual67
office were more likely to report a willingness to give
68
extra effort towards helping their company succeed,
69
more motivation, and higher job retention rates than70
those working in a traditional office [6]. Although
71
telework implementation is thought to strengthen an72
individual’s work/life balance, a worsened work/life73
balance was found in prior research [6]. Here, the
74
obstacles faced by teleworkers may be a combi-75
nation of the ability to perform multiple, distinct
76
(work/domestic) tasks at once and a lack of externally
77
imposed physical boundaries, muddying the distinc-78
tion between work-life and home-life areas/spaces79
[6].80
Unfortunately, this transition to telework has81
become a “new normal” phenomenon which may ulti-82
mately result in emerging ergonomic issues. Regard-
83
less of where work is completed, poor posture while84
operating a computer or laptop can cause stiffness,
85
soreness, back pain, sore neck, and eye fatigue. How-86
ever, laptop use has been found to have a greater risk87
[8]. Additionally, the chair height and the armrest88
position has been associated with musculoskeletal89
pain if positioned or used improperly [9]. Current90
home office arrangements may range from a com-91
puter atop a kitchen table, a laptop used in a recliner,
92
or work being completed while sitting in a bed or on
93
the floor [10]. None of these workstations are geared
94
for completing a full day of work, especially from
95
an ergonomic perspective. For example, the use of a 96
laptop while seated on a couch caused awkward wrist 97
postures while typing on the keyboard or activation 98
of the touchpad, arms not supported, placing stress 99
on the upper back, and neck flexed to look down 100
at the screen [11]. Individuals using external input 101
devices such as a keyboard and mouse tend to report 102
less computer-related discomfort than laptop devices 103
[12]. 104
While there is ample published evidence regard- 105
ing the relationship between poor office ergonomics 106
and a heightened risk of musculoskeletal injuries 107
[13–17], there is not much evidence that exists regard- 108
ing workstations in telework, including home-based 109
work environments necessitated by the COVID-19 110
pandemic. The study’s goal was to survey the faculty, 111
staff, and administrators at a large public urban Mid- 112
western university about their home office, specifica- 113
lly the ergonomic stressors and muscular discomfort, 114
to characterize the prevalence of these stressors and 115
discomfort. In addition, correlation and regression 116
analyses were conducted to investigate the relation- 117
ship between office exposures and discomfort. 118
2. Methods 119
2.1. A. Study design 120
The survey was a cross-sectional evaluation of the 121
conditions in the home offices of the university’s 122
employees. On April 14, 2020, a survey investigat- 123
ing the ergonomic stressors and discomfort for home 124
offices was sent to all staff, administration, and fac- 125
ulty members of the University of Cincinnati. 126
2.2. B. Home office survey 127
The survey was developed in REDCap (Cincin- 128
nati Children’s Hospital Medical Center, Cincinnati, 129
OH). The survey inquired about demographic infor- 130
mation: employment position at the university, age, 131
and gender; type of computer device used: laptop, des- 132
ktop, tablet, or another device; type of chair used: 133
office chair with armrests, office chair without arm- 134
rests, kitchen/dining chair, folding chair, couch or 135
sofa, bed, armchair or recliner, or other types of 136
seating; type of monitors: built-in laptop screen, 137
external monitor, two stand-external monitors, lap- 138
top screen-external monitor combination, or other; 139
type of input device used: built-in keyboard, exter- 140
nal keyboard, traditional mouse, built-in mouse pad, 141
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T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic 3
trackball, touch screen, stylus, or other input devices;142
and type of worksurface used: traditional desk,143
makeshift desk, sit/stand workstation store-bought,
144
makeshift sit/stand workstation, not on a work sur-145
face, or another work surface. The factors were rated146
as always, often, sometimes, seldom, or never used
147
concerning the time spent on average per working
148
day following the beginning of working from home.
149
The survey also asked about the respondents’ stress/
150
tiredness level relative to the typical stress and fatigue151
levels experienced in the typical office setting. Addi-152
tionally, the level of discomfort in body regions,153
including head/neck/eyes, upper back/shoulders, and
154
lower back, was investigated. A final section for open155
comments was provided for respondents to express
156
additional concerns.
157
2.3. C. Study population158
This study was specifically limited to faculty, staff,159
and administration employed by the University of160
Cincinnati, with a population of nearly 10,350 indi-161
viduals [18]. Of this population, 843 individuals
162
returned surveys about their home office that resulted163
from the ongoing COVID-19 pandemic.164
2.4. D. Data analyses plan
165
Descriptive statistics were determined for each
166
variable, including frequency and percentage of sam-167
ples responded. Statistical analyses consisted of168
univariate correlations of all ergonomic exposures
169
and discomfort variables and linear regression mod-170
els. Two sets of regression models were developed171
utilizing stepwise regression and theoretical a priori172
models: 1) set of models predicted the 9-body regions173
based on the workplace exposure variables, and 2)174
set of models predicted the tiredness and stress based175
on the workplace exposure variables. All regression 176
relationships were significant, as defined by having a 177
p-value < 0.05. 178
3. Results 179
3.1. A. Workplace concerns 180
Overall, 843 surveys were completed (see Table 1). 181
Most respondents were faculty (n= 577), followed by 182
staff (n= 227) and administration (n= 20). A majority 183
of the respondents were female (n= 509, 60%). More 184
than half of the survey population (54%) were 50 185
years of age or under (n= 456). 186
Device usage can be found in Fig. 1 and reveals 187
laptops are widely used in home offices. Nearly 70% 188
(n= 579) of the participants reported using a lap- 189
top “always”, while 15% (n= 115) and 3% (n= 23) 190
Fig. 1. Frequency of Use for Each Computer Type.
Table 1
Demographic Information of Survey Respondents
Faculty Staff Administration No Response Overall
Total 577 227 20 19 843
Age Less than 30 7 29 0 36
Age 31 to 40 121 78 2 201
Age 41 to 50 162 52 5 219
Age 51 to 60 163 40 9 212
Age 61 to 70 99 25 4 128
Age 71 and above 21 3 0 24
No response 4 0 0 19 23
Male 223 60 6 289
Female 337 160 12 509
Other 0 1 0 1
No response 17 6 2 19 44
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4T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic
Fig. 2. Frequency of Use for Each Chair Type.
reported always using a desktop and tablet, respec-191
tively. Another device, which was predominantly a
192
mobile device, was used “often” or “sometimes”193
about 43% of the time.194
The type of chair used in the home office seemed to195
vary widely between participants (see Fig. 2). While
196
44.6% (n= 347) of the participants reported “always”
197
or “often” using an office chair with armrests—the
198
recommended seat from an ergonomic perspective,
199
many use chairs with no armrests as 44.7% (n= 348)
200
reported never using an office chair with armrests.
201
The extensive usage of chairs without armrests was
202
widely prevalent as respondents reported “always”,
203
“often” or “sometimes” for usage of dining chair204
56.6% (n= 427), couch 36.6% (n= 266), folding205
chair 7.2% (n= 50), bed 12.0% (n= 84), and arm-
206
chair 15.7% (n= 110). Additionally, these chairs were207
often sub-optimal with no adjustable arms and lumbar208
support. Indeed, only 21.6% (n= 182) of the respon-
209
dents reported using a chair with adjustable armrests
210
and 30% (n= 253) reported using a chair with either
211
built-in lumbar support or lumbar support which had
212
been added to the chair. Another chair related factor
213
that can cause problems to the worker is the lack of214
proper support to the back from the chair. Roughly215
two-thirds of respondents (n= 534, 64.4%) noted they216
“sometimes”, “seldom”, or “never” have their back in217
contact with their chair.
218
Regarding the screen options used in the home 219
office, many respondents reported “always” using a 220
built-in laptop screen (n= 435, 55.1%) while also 221
reporting “never” using alternative (external moni- 222
tor, n= 426 or 60.4%, two external monitors, n= 554, 223
83.1%) or supplemental monitor to the laptop (n=224
414, 56.6%) (as seen in Fig. 3). Similarly, regarding 225
Fig. 3. Frequency of Use for Each Screen Type.
Fig. 4. Frequency of Use for Each Input Device.
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T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic 5
Fig. 5. Frequency of Use for Each Workstation Type.
input devices, many responded “always” using a lap-226
top keyboard, albeit with an external mouse, but never227
using more ergonomically friendly tools such as an228
external keyboard. As seen in Fig. 4, 46.7% (n= 394)
229
of respondents reported “always” using a laptop key-
230
board compared to 21.8% (n= 187) “always” using
231
an external keyboard. A similar pattern was observed
232
with the use of a mouse as 36.4% (n= 307) of respon-
233
dents reported “always” using a traditional mouse,
234
21.1% (n= 178) reported “always” using a laptop
235
mouse.236
The results were fairly mixed with regard to the237
type of workstation being utilized while in the home238
office (Fig. 5). While greater than half of the res-239
pondents (n= 434, 54.8%) stated they “always” or240
“often” use a traditional desk, the remainder appear241
to work from either makeshift desks (n= 316, 41.0%)242
or no worksurface at all (n= 90, 12.3%). Few respon-243
dents utilized a sit-stand workstation “always” or244
“often” (store bought n= 41, 5.7%, makeshift n= 39,245
5.5%). With many of the workstations, users often246
had to type in the presence of a hard-front edge of the247
worksurface. Nearly half of the respondents (n= 390,248
52.1%) noted their desk had a sharp edge along the249
front.250
Many of the workstations and working practices
251
yielded poor body postures. There were many par-
252
ticipants who perceived poor postures when working
253
at home such as roughly 40% (n= 323) stated their 254
backs were bent “always”, “often”, or “sometimes” 255
and nearly three-fourths (n= 625) reported their 256
head/neck being tilted forward “always”, “often”, 257
or “sometimes”. In addition,18% (n= 153) and 28% 258
(n= 234) of respondents reported their head/neck was 259
tilted backward or sideways, respectively. 260
Approximately half of the respondents (n= 426) 261
reported glare was present on their worksurface and/ 262
or screen “always”, “often”, or “sometimes”. Nearly 263
three-fourths of respondents (n= 603) reported they 264
work for a duration greater than one hour without 265
taking a break. Two-thirds of the respondents (n=266
570) reported they only walk one to four times 267
during the day for more than five minutes. Regarding 268
whether the participant wears glasses, the answers 269
were comparable between “yes, bifocal”, “yes, 270
non-bifocal”, and “no” with 30.01%, 32.41%, and 271
37.58%, respectively. 272
3.2. B. Adverse impact on workers 273
Many of the responses from the home office work- 274
ers raise concern for impacts on their long-term 275
health. More than half of the survey respondents 276
reported their stress levels and tiredness levels have 277
increased since the transition to a home office work 278
environment. Specifically, 54.2% (n= 457) of respon- 279
dents stated their stress level had either increased 280
slightly more than usual, somewhat more than usual, 281
or a lot more than usual. Regarding fatigue, 50.9% 282
(n= 429) of the respondents stated their tiredness 283
level had either increased slightly more than usual, 284
somewhat more than usual, or a lot more than usual as 285
compared to prior to working at home due to COVID- 286
19. 287
Discomfort was very prevalent in the faculty and 288
staff completing the survey (see Fig. 7). More than 289
three-fourths of the respondents (n= 652, 78.5%) 290
stated they experienced little to no discomfort while 291
working in their normal office setting prior to 292
COVID-19, and 21.5% of these workers had mod- 293
erate to severe discomfort in at least one region of 294
the body. As the faculty and staff were compelled 295
to telework, discomfort seemed to increase. While 296
teleworking, greater than 40% of survey respon- 297
dents noted moderate to severe discomfort levels in 298
the eyes/neck/head, upper back/shoulders, and lower 299
back regions (46.98% (n= 396), 49.70% (n= 419) 300
42.82% (n= 361), respectively).
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6T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic
Fig. 6. Frequency of Time Spent in a Poor Body Posture for Back and Head/Neck.
3.3. C. Correlations
301
3.3.1. I. Computer devices, workstations, and
302
input devices
303
As would be expected, laptop use was inversely
304
related to desktop computer usage (r= –65, p<305
0.0001) and tablet usage (r= –0.11, p< 0.05). Tablet306
usage was correlated with alternative device usage307
(r= 0.22, p< 0.001). Use of an office chair with arm-308
rests was negatively correlated with laptop usage309
(r= –0.20, p< 0.0001) and positively related to
310
desktop computer usage (r= 0.38, p< 0.0001). The
311
opposite was the case for dining room chair (laptop:
312
r= 0.25, p< 0.0001 and desktop computer: r= –0.25,313
p< 0.0001), couch (laptop: r= 0.12, p< 0.001 and314
desktop computer: r= –0.15, p< 0.0001), and bed315
(laptop: r= 0.08, p< 0.04 and desktop computer: r=316
–0.10, p< 0.01). Usage of a couch was found to be317
correlated to bed usage (r= 0.34, p< 0.0001). Sig- 318
nificant correlations in the positive direction was 319
found for laptop and laptop monitor usage (r= 0.44, 320
p< 0.0001), laptop and laptop keyboard (r= 0.46, p<321
0.0001), laptop and laptop mouse (r= 0.39, p<322
0.0001), desktop computer and external monitor (r=323
0.62, p< 0.0001), desktop computer and two exter- 324
nal monitors (r= 0.36, p< 0.0001), desktop computer 325
and external keyboard (r= 0.63, p< 0.0001), desk- 326
top computer and traditional mouse (r= 0.42, p<327
0.0001), office chair with armrests and external mon- 328
itor (r= 0.37, p< 0.0001), desktop computer and 329
traditional office desk (r= 0.34, p< 0.0001), dining 330
chair and makeshift desk (r= 0.58, p< 0.0001), lap- 331
top and makeshift desk (r= 0.23, p< 0.0001), couch 332
and no workstation (r= 0.59, p< 0.0001), bed and 333
no workstation (r= 0.34, p< 0.0001), laptop moni- 334
tor and no workstation (r= 0.25, p< 0.0001), laptop 335
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T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic 7
Fig. 7. Discomfort in the Home Office by Body Area.
monitor and makeshift desk (r= 0.29, p< 0.0001),336
laptop keyboard and makeshift desk (r= 0.27, p<337
0.0001), laptop mouse and makeshift desk (r= 0.22,
338
p< 0.0001), and traditional mouse and traditional
339
office desk (r= 0.32, p< 0.0001).
340
3.3.2. II. Other factors341
Several factors were positively associated with
342
back support including: desktop computer (r= 0.09,343
p< 0.01), office chair with arm rests (r= 0.24, p<344
0.0001), external monitor (r= 0.10, p< 0.01), exter-345
nal keyboard (r= 0.14, p< 0.0001), traditional mouse
346
(r= 0.12, p< 0.001), and traditional desktop (r= 0.22,347
p< 0.0001). One key correlation was found for expo-348
sure to sharp front edge of the desk which was
349
office chair without armrests (r= 0.10, p< 0.01).
350
There was a positive correlation between glare and
351
laptop usage (r= 0.10, p< 0.004), couch (r= 0.19,
352
p< 0.0001), bed (r= 0.12, p< 0.0001), and makeshift
353
desk (r= 0.20, p< 0.0001). Adjustable armrests and
354
lumbar support were positively correlated with desk-355
top (r= 0.15, p< 0.03) and office chair with arm rests356
(r= 0.15, p< 0.002 and (r= 0.36, p< 0.0001, respec-357
tively). There were no significant correlations with358
time without a break and number of times walking
359
more than 5 min.
360
Table 2
Regression Models for Stress and Tiredness Variables
Stress
Beta P-Value Partial
R-squared
Intercept 1.96
Time without break –0.12 0.002 0.01
Glare 0.25 <0.0001 0.05
Age 0.11 0.001 0.01
Laptop keyboard 0.08 0.01 0.01
Tiredness
Intercept 1.68
Glare 0.27 <0.0001 0.08
Bed workstation 0.12 0.002 0.01
3.4. D. Regression 361
3.4.1. I. Stress and tiredness 362
Increased age, glare, and laptop keyboard usage 363
increase stress (Table 2). Increased time between 364
breaks was found to actually decreases stress (r=365
–0.12). Two factors influenced the tiredness work- 366
ers felt with increased glare and time working on the 367
bed increasing the tiredness. 368
3.4.2. II Workplace factors impacting body 369
discomfort 370
Table 3 provides a summary of the regression mo- 371
dels for the discomfort for the 9 body regions utiliz- 372
ing the office workstation factors. In all one body 373
region (exception hips and legs), increased glare 374
increased discomfort. Another factor that appeared 375
to contribute to discomfort (6 out of 9 regions) was 376
use of back support of chair where less time spent 377
in contact increased discomfort (r ranged between 378
–0.24 to –0.47). Additional contributing factors of 379
note are: 1) females had less discomfort for eye, 380
neck, and head; hips and upper legs; and upper back 381
and shoulders regions, 2) working in non-traditional 382
workstations increased discomfort such as couch for 383
eyes, neck, and head and dining chair for middle back, 384
and 3) sit-stand workstation for lower arms, wrists, 385
and hands. Use of adjustable armrests was protective 386
with respect to discomfort for lower arms, wrists, and 387
hands. 388
4. Discussion 389
Of the population employed by the University of 390
Cincinnati, 843 individuals returned the surveys. 391
From this data, an alarming proportion of employees 392
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8T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic
Table 3
Regression Models for Body Discomfort utilizing Workplace Factors
Eyes, Neck, and Head Upper Back and Shoulders
Beta P-Value Partial Beta P-Value Partial
R-squared R-squared
Intercept 5.20 Intercept 4.20
Glare 0.81 <0.0001 0.12 Glare 0.69 <0.0001 0.10
Back in contact with chair –0.26 0.008 0.02 Gender –0.93 <0.0001 0.04
Couch workstation 0.19 0.05 0.01 Sharp edge on desk 0.25 0.04 0.01
Gender –0.59 0.01 0.01 Back in contact with chair –0.31 0.001 0.02
Upper Arms and Elbows Lower Arms, Wrists, and Hands
Intercept 2.59 Intercept 5.06
Glare 0.45 <0.0001 0.05 Glare 0.66 <0.0001 0.08
Laptop with –0.13 0.02 0.01 Sit-Stand workstation 0.25 0.05 0.01
External Monitor (bought)
External Keyboard 0.15 0.05 0.01
Adjustable armrests –0.51 0.05 0.01
Middle Back Lower Back
Intercept 4.55 Intercept 4.51
Back in contact with chair –0.47 <0.0001 0.05 Back in contact with chair –0.46 <0.0001 0.04
Glare 0.72 <0.0001 0.07 Glare 0.72 <0.0001 0.07
Laptop keyboard –0.21 0.01 0.01
Dining chair 0.17 0.03 0.01
Hips and Upper Legs Knees and Lower Legs
Intercept 0.17 Intercept 0.88
Back in contact –0.38 <0.0001 0.03 Back in contact with chair –0.24 0.001 0.02
with chair
Gender –0.58 0.006 0.01 Glare 0.29 0.0001 0.02
Time without break –0.30 <0.0001 0.02
Ankles and Feet
Intercept 2.16
Glare 0.30 <0.0001 0.03
(more than 40%) noted discomfort in various body393
areas, such as the: eyes/neck/head, upper back/394
shoulders, and lower back while teleworking. Com-395
paring this percentage to the fact more than 75% of396
respondents stated they experienced little to no dis-397
comfort in their typical office setting prior to COVID-
398
19, it is clear there has been a dramatic increase
399
in discomfort symptoms following the transition to
400
telework. This increase in symptoms could certainly
401
be explained by the transition of on-site office work
402
to remote telework. One of the most prominent403
office concerns would be the extensive use of laptops404
(∼70% reported “always” using a laptop). Previous
405
studies have shown usage of laptop computers, often-406
times in sub-optimal workstations caused awkward407
wrist postures during typing on keyboard or activation408
of touchpad, arms not supported placing stress on the409
upper back, and neck flexed to look down at the screen
410
[11]. However, it is important to note due to the nature
411
of the pandemic recall bias could impact the results412
of discomfort within the participants’ responses. In413
a sub-set of the survey participants, pictures of the414
workstations for 41 faculty/staff (self-selected) were 415
analyzed to identify actual ergonomic concerns [10]. 416
These pictures revealed laptops were often used, 417
resulting in poor postures due to too low of a monitor, 418
no external keyboards, and makeshift workstations. 419
Correlation analysis showed strong relationships 420
between laptop usage and suboptimal workstation 421
conditions, namely lack of a good chair with adjus- 422
table armrests and lumbar support and reduced use of 423
a desk or other furniture that allowed the monitor to 424
be correctly positioned while working. Prior research 425
has shown laptop computer usage, which is typically 426
coupled with suboptimal workstation setups, results 427
in awkward wrist placements while typing on a key- 428
board or using the touchpad, a lack of support for the 429
arms, which in turn places stress on the upper back, 430
and increased strain on the neck which is flexed to 431
look down at the screen [11]. An external monitor 432
properly positioned with top of screen at eye height 433
and directly in front of the worker would reduce the 434
awkward postures of arms, neck, and back likely con- 435
tributing to the high levels of discomfort. Further, the 436
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T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic 9
benefits of an external mouse and keyboard would437
enable an individual to maintain proper more neutral
438
hand postures as well as when an external monitor439
is not available would allow laptop monitor to be440
elevated to an appropriate height. The impact of a441
poor monitor height maybe further exacerbated by
442
high number of people with bifocals (30%) which443
was significantly higher than previous studies (10%)444
[19].445
A proper workstation should consist of an exter-
446
nal monitor positioned with top of screen directly447
in front of the worker at eye level and would cor-448
rect the awkward postures of the arms, neck, and
449
back likely contributed to the high levels of discom-450
fort [10]. Additionally, the use of an external mouse
451
and keyboard would enable an individual to maintain452
more neutral hand postures, and (in the absence of an453
external monitor) would allow a laptop monitor to be
454
elevated to the appropriate height [10]. Another major455
potential contributor to adverse health was the lack456
of a good ergonomic chair that includes adjustable457
armrest, five casters, good back with a lumber sup-458
port, and adjustable seat height. Respondents using a459
laptop were statistically more likely to make a poor460
selection in seating such as a dining chair, a couch,
461
or a bed, if they used a worksurface at all, as opposed
462
to a traditional desk.463
Laptop use was strongly correlated with non-
464
traditional workstations such as a bed or couch which465
did not provide adequate lumbar support or proper466
elevation of the monitor. Seating positions that did
467
not provide good back support (measured as frequent468
back contact with a chair back) showed a higher likeli-
469
hood of discomfort in the eyes, neck, and head; upper
470
back and shoulders, lower back; hips and upper legs;471
and knees and lower legs. On the other hand, lap-472
tops were inversely correlated with adequate lumbar473
support, glare, and chairs without armrests. This indi-474
cates not only is there a high level of use of laptops475
but oftentimes they are utilized in less than optimal
476
ergonomic conditions such as the back bent forward,477
neck bent forward or sideways, and was also corre-
478
lated with experiencing increased levels of stress and479
tiredness since beginning work from home.480
The use of a desktop had positive associations with481
office chairs with armrests, a chair with armrests, and482
a chair with lumbar support. As a result, while tra-483
ditional office workstations (e.g. desktop computer,484
external monitor, external keyboard and mouse, and
485
office chair with adjustable armrests) were not widely
486
used, they were associated with less poor ergonomic
487
concerns (e.g. glare, no lumbar support). Desktop
488
use also showed a higher likelihood of using one or 489
more external monitors, an external keyboard, and 490
traditional mouse, as well as a traditional or sit/stand 491
desk–all of which contributed to a decrease in physi- 492
cal discomfort particularly in the lower arms, wrists, 493
and hands, as well as areas affected by the head and 494
neck being bent forward. In a time of expedited shift 495
to the home and limited resources due to the down 496
turn in the economy, many individuals have shifted to 497
makeshift workstations which many not adequately 498
protect workers [20]. 499
Several key results were found from the regression 500
analyses, many of which centered around the idea the 501
principles of good workstation seem to disappear as 502
more elements not designed for the specific task are 503
introduced. First, glare was a dominant stressor for 504
having body discomfort in most of the body regions 505
(exception upper leg and hips). Glare appeared to 506
impact several body postures which produced more 507
flexion in the neck and back as well as neck bent 508
sideways. These postural responses were also found 509
to be related to the discomfort, thus, glare seems to 510
perpetuate through body adjustments that lead to the 511
increased discomfort. Second, lack of having contact 512
with the back of the chair was found to impact the 513
discomfort in most body regions (all but upper arms 514
and elbow; lower arms, wrist, and hands; ankles and 515
feet). Less than half of respondents always or often 516
used an office chair with armrests and less than a quar- 517
ter of respondents used an office chair with adjustable 518
armrests. The relationship between lack of back sup- 519
port and discomfort would likely be driven by the 520
increased muscle stress required to support the dif- 521
ferent body regions. Moreover, while a slight majority 522
of respondents reported typically using a traditional 523
desk to complete work, many utilized makeshift or 524
improvised work surfaces, such as a kitchen table 525
or counter, card tables, or from living room furniture 526
or bed. When a workstation becomes more and more 527
makeshift, the principles of good office ergonomics 528
appear to dissipate, resulting in poor postures and 529
increased discomfort. Makeshift workstations may 530
have led to uses of components in manners for which 531
they were not originally designed or not fully adjusted 532
to the worker appropriately [20]. 533
Third, the significant effect of sharp edge for upper 534
back and shoulder would likely be due to changes in 535
arm posture in response to contact stress on the fore- 536
arms. Fourth, distal upper extremity discomfort was 537
reduced by adjustable armrests and use of external 538
keyboard. Finally, dining room chair was signifi- 539
cantly related to middle back discomfort where more 540
Uncorrected Author Proof
10 T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic
time in the chair increased pain, likely due to the lack541
of back support. In all, many of the poor ergonomic
542
conditions were related to increased discomfort.543
A couple of other negative outcomes for home544
office work is the increase in stress and tiredness.545
This increase in adverse responses may reflect addi-
546
tional complexities workers face in a work-home547
environment, such as less work/life balance and548
reduced personal/family success compared to indi-549
viduals in a typical office setting [6]. The slight
550
majority of respondents stating their tiredness lev-551
els have increased since the transition to telework552
began and the slight majority who reported increased
553
stress levels may reflect the complexities workersface554
in a work-home environment. Prior research showed
555
working at home caused less work/life balance and556
reduced personal/family success compared to indi-557
viduals in a typical office setting [6]. This could be
558
caused from employees lacking satisfactory physical559
boundaries at their residence. Possibilities of working560
towards stress minimization could come in the form561
of discussing with one’s supervisor the opportunity562
to modify one’s own daily schedule, creating a more563
“results-oriented” mindset [7]. Again, glare appears564
to be a contributor to both stress and tiredness. Lack of
565
breaks was also found to significantly increase stress.
566
Individuals could also find ways to integrate more567
physical activity into the day as roughly two-thirds
568
of respondents reported they only walk for more than569
a five-minute interval up to four times a day [7]. It is570
important to move every 30 minutes to increase large
571
muscle activation and reduce static postures, and most572
likely reduce stress [21]. Increase time working on the
573
bed also increases the tiredness, likely due to poor
574
static postures that need to be held.575
The results of this study demonstrate there are576
opportunities for improvement in ergonomics within577
the home office. Proper training in ergonomics has578
been found to be effective in reducing discomfort in579
teleworkers and in-person office workers alike [22,
580
23]. With 25–40% of respondents noting they typi-581
cally use dining chairs, recliners, a laptop keyboard,
582
or poor worksurfaces, the importance of increas-583
ing office ergonomic awareness, as well empowering584
home office workers to make positive changes is585
certain [24]. As the effects of the pandemic on work-586
forces continue to evolve with little certainty, there587
is a strong case that improved workspaces will not588
only be beneficial for the workers but may also be
589
financially advantageous for employers. Providing
590
better support for the physical and mental health of
591
their employees could reduce potential downtime and
592
compensation claims attributed to injuries from sus- 593
tained strain in non-ergonomic conditions. 594
4.1. A. Limitations 595
The survey used for this analysis was provided to 596
only the faculty, staff, and administration of a single, 597
public, urban university within the U.S. For this rea- 598
son, the findings of this study may not completely 599
reflect workers in general but do provide insight into 600
common concerns of home offices. For example, indi- 601
viduals employed in more rural settings may have 602
poor home internet reliability and could have fewer 603
options within the household with which to create a 604
makeshift home office. 605
Second, the survey was based on the perceptions of 606
the individuals, especially with respect to the postures 607
and discomfort. Subjective perceptions regarding the 608
organization of the home office have the potential 609
for bias as they relate to the adverse impact of being 610
home and COVID-19. Perceptions of using various 611
devices were likely more accurate but biased as it 612
can be difficult to estimate “how much” they were 613
used, except in the case when they only used a set-up 614
with one device (e.g. laptop only at a desk). Future 615
work should investigate how employees are working 616
in offices at home as the pandemic continues beyond 617
the initial stay-at-home phase. The increases in stress 618
and fatigue reported could be explained by COVID- 619
related (fear of infection, fear of job loss) stressors 620
rather than due only to the stress of moving to a home 621
office. 622
Third, since the pandemic situation created a 623
mass need for telework among the “non-essential” 624
industries all data collected was retrospective. Since 625
pre-COVID-19 telework data evaluating similar 626
ergonomic issues at the University of Cincinnati was 627
not available, a control group for the study could 628
not be assigned. It is likely that planned telework 629
pre-COVID 19 would include a better set up for a 630
home office compared to make shift telework ini- 631
tiated by the pandemic. Employers and employees 632
would likely be more aware of items needed for a suc- 633
cessful home office for a job designed for telework 634
compared to an in-office work environment. 635
Finally, while 843 is a large number of responses, 636
it represented a less than 10% response rate. The rel- 637
atively low percentage could mean the results were 638
subjected to selection bias. If a bias exists, the per- 639
centage of discomfort and poor postures maybe over 640
estimated due to negative effect.
Uncorrected Author Proof
T. Gerding et al. / Home offices of university employees sent home due to the COVID-19 pandemic 11
5. Conclusion641
The results from this study illustrate the appar-642
ent level in discomfort experienced by university643
faculty, staff, and administration brought about by
644
the ongoing COVID-19 pandemic. Large increases645
in discomfort levels following the stay-at-home646
orders were observed. Many potential sources of this647
increase in discomfort were reported such as wide
648
use of laptops, working at sub-optimal workstations
649
such as couches, beds, and kitchen countertops. Tele-650
work has led to many adverse working conditions651
such as laptops with monitors too low, chairs with-
652
out armrests, hard edge on desktops surfaces, and653
long static postures due to lack of routine breaks.654
As we have converted to home offices, employees655
don’t have the resources to adequately set up work-
656
stations at home. Companies and institutions need to657
ensure workers have proper equipment including an658
adjustable office chair with armrests, a monitor that659
can be set to eye height, and an external keyboards and
660
mouse. Additionally, it is recommended companies661
and institutions provide proper ergonomic training to
662
their employees to prevent potential musculoskeletal663
disorders from developing.664
6. Recommendations665
A few recommendations that could be helpful for
666
the home-office worker:
667
•Placing a pillow on the seat can elevate the seat668
height to an appropriate height.669
•Placing a pillow or rolled up towel behind your
670
back may provide lumbar and back support with a
671
chair that does not have lumbar support built into
672
the chair back.673
•Wrapping armrests when they are low and not
674
adjustable may help for better arm positioning.
675
•Moving your chair closer to the desk or table can
676
encourage maintaining the back against the back677
of the seat.678
•If a laptop is too low in relation to head height,679
placing a lap desk or large pillow under the laptop
680
to raise the monitor when using it on the lap should681
help.682
•Using an external keyboard and mouse will help
683
with reducing awkward wrist postures.684
•An appropriate standing workstation should have685
the top of the monitor at eye height and directly686
in front, keyboard at a height so that forearms are687
parallel to the ground (approximately 90◦elbow 688
angle), and a soft or rounded front edge to the 689
working surface. 690
•If obtaining a new chair or identifying an appro- 691
priate sitting workstation at home is not possible, 692
rotating between a poor sitting workstation and 693
a standing workstation would be the next best 694
practice. There are many simple, makeshift stand- 695
ing workstations available in the home, including 696
implementing the use of an ironing board, a 697
kitchen counter, the top of a piano, a clothes bas- 698
ket placed upside down on a table or desk or a 699
large box under the laptop. 700
Conflict of interest 701
The authors have indicated they have no potential 702
conflicts of interest to disclose. 703
Funding 704
This work was supported by the National Institute 705
for Occupational Safety and Health through the Uni- 706
versity of Cincinnati Education and Research Center 707
(#T42OH008432). 708
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