Stephen Walsh looks at startling evidence which reveals that computer use can be linked to a common eye disease

New medical research has for the first time suggested a link between long-term computer use and eye disease. If substantiated, this could lead to glaucoma becoming the next long-tail disease to hit employers' liability insurers.

A recent Japanese study of 9,000 workers employed in the electronic and steel industries published in the December 2004 issue of the Journal of Environmental & Community Health has found an association between long-term heavy computer use and an increased risk of developing glaucoma. Further research is required to confirm the link and ascertain the extent of the problem.

Heavy users
The report classes those who work with computers for eight or more hours per day as "heavy" users. Only those with myopia (short-sightedness) are at increased risk. The report noted the opposite effect on test subjects with normal sight - the risk actually decreased as computer use increased.

Smoking and high blood pressure are other risk factors. The risk increases over time, with those who have used computers for more than 20 years at the greatest risk.

When coupled with the shift from manufacturing to ‘white collar' work in the UK and the increase in display screen use over the past decade, the report's findings raise the potential that glaucoma could become a long-tail disease problem for insurers in years to come.

It is estimated that about 500,000 people in England and Wales currently suffer from glaucoma. It is caused by a build-up of pressure on the optic nerve and it is the leading cause of preventable blindness. If detected early enough it can be treated with drops, laser or conventional surgery.

The report found that just over 5% of the employees surveyed had visual field abnormalities. A third of these, about 1.8% of the total, had suspected glaucoma. This is almost double the usual figure of 1% for the population at large.

Claims could range in value from £1,250, where the problem is detected early and successfully treated, to several hundred thousand pounds, where the condition causes blindness and the employee is unable to return to work.

The Japanese study is not sufficient on its own to establish legal liability, but as the experience with asbestos has shown, as scientific knowledge of a condition increases and a causal link is established employers can be found liable for breaches of legislation that occurred many years before.

Claims for asbestos exposure dating back as far as the 1930s continue to be brought successfully on the basis of breaches of the 1937 Factories Act, specifically the duty on employers to take steps to reduce general dust levels.

The courts have in a number of cases found employers liable under the 1937 Act, notwithstanding the fact that the causal link between moderate or mild asbestos exposure and conditions such as mesothelioma and lung cancer were not identified until the 1960s.

There is a potential parallel here with the Workplace (Display Screen Equipment) Regulations, which are supported by HSE Guidance L26. The regulations have been in force since January 1993 and provide:

  • Workstation assessments must be undertaken for every workstation and reviewed regularly (reg 2).
  • Screen images should be stable, with no flickering, have adjustable contrast and should be free from glare
  • Room lighting must provide an "appropriate" contrast between the screen and background environment
  • Finally, employers must ensure that employees have regular breaks from display screen work, either through changes in work activity or regular breaks (regulation 4). Note that it is the employer's duty, not the employee's, to plan the employee's working day.
  • Employers are currently under an obligation to provide free eye tests under regulation at the employee's request (regulation 5), but there is no duty to do so if the employee does not ask.

    Furthermore, the visual examination that forms part of the mandatory test will only find 25% of glaucomas, so an employer will not be able to rely on a satisfactory test result if the workstation is subsequently found to be unsatisfactory.

    If the link between heavy screen use and glaucoma is confirmed, there will be difficult questions to be dealt with in individual cases. For example, will a general instruction to employees to take regular breaks be sufficient to avoid liability, or do employers need to do more by actively monitoring screen use (for example, through keystroke activity monitoring or otherwise)?

    Are employees who spend a significant proportion of their private time on home computers contributorily negligent? At what point might the manufacturer come under a duty to publish warnings?

    Finally, claims for exposure today might not be made for 20 or more years, so it is important to ensure that there is an adequate system in place to ensure documents, such as workstation assessments and advice to employees, are retained and details of the relevant insurer and policy numbers are kept.

    ‘ Stephen Walsh is a partner at Hill Dickinson

    How employers can minimise the risk of glaucoma claims
    It is still too soon to say with any certainty what action will be required to avoid the problem, if any.

    But to minimise their organisation's exposure to potential future claims, risk managers and those with responsibility for health and safety should:

  • Ensure workstation assessments are up to date
  • Ensure that employees are given advice on how to position their computer screens and told to take regular ‘eye breaks' every 20 minutes or so
  • Advise employees of their right to a free eye test
  • Keep abreast of further studies in the event a positive link is established.
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