BACKGROUND: During many years of occupational stress research, mostly within the German governmental program for "Humanization of Work Life'', remarkable deficits concerning visual work were seen, the most striking being the lack of cooperation between the different experts. OBJECTIVE: With regard to this article hard arguments and ideas for solutions had to be found. METHODS/PARTICIPANTS: A pilot study in 21 enterprises was realized (1602 employees with different visual work tasks). A test set of screening parameters (visual acuity, refraction, phoria, binocular cooperation and efficiency, accommodation range and color vision) were measured. The glasses and/or contact lenses worn were registered and the visual tasks analyzed. In work at visual display units (VDU) the eye movements were recorded and standardized questionnaires were given (health, stress, visual work situation). Because of the heterogeneity of the sample only simple statistics were applied: in groups of different visual work the complaints, symptoms, hassles and uplifts were clustered (SAS software) and correlated with the results of the visual tests. Later a special project in 8 companies (676 employees) was carried out. The results were published in [14]. RESULTS: Discomfort and asthenopic symptoms could be seen as an interaction of the combination of tasks and working conditions with the clusters of individual functionalisms, frequently originating in postural compromises. Mainly three causes for stress could be identified: 1. demands inadequate with regard to intensity, resolution, amount and/or time structure; 2. prevention of elementary perceptive needs; 3. entire use of partial capacities of the visual organ. Symptoms also were correlated with heteronomy. Other findings: influence of adaptation/accommodation ratio, the distracting role of attractors, especially in multitasking jobs; influence of high luminance differences. Dry eyes were very common, they could be attributed to a high screen position, low light, monotonous tasks and office climate. For some parameters a diurnal rhythm could be identified. Nowhere special programs for ageing employees were found: the right glasses; retinal problems and signs of destabilization of vision. CONCLUSIONS: In all enterprises, the ergophthalmological and visual ergonomic knowledge of the occupational physicians was poor, visual ergonomists were not available and there was only very poor cooperation with ophthalmologists and optometrists, the first of whom additionally had not much knowledge of modern work.
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