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Road-kill on the information highway: repetitive strain injury in the academy.

Introduction

In an early interrogation of geographic information systems (GIS) in geography, Pickles (1993) and Sheppard (1993) criticised the positivist assumptions of most automated geographies. Pickles (cf. Haraway 1991) questioned the impacts of computing on individual identities, bodies and the prosthesis-like quality of human-computer interactions. He noted the shortage of critical reflection on how computing affects various types of social relations, including labor relations and 'the labor process within the academy' (Pickles 1993, 452). Sheppard (1993, 459-60) also argued that the adoption of technology should be investigated as a social process--and as an irreversible process, as societies seldom revert back to less sophisticated older technologies.

A decade later, thanks to desktop and laptop computers of various kinds, PowerPoint presentations, the Internet and listservs, IT in geography pervades the entire discipline, not just the 'technical' specialties like GIS. IT is rapidly commanding a niche in cultural studies in its own right (Crang, Crang and May 1999; Jordan 1999; Dodge and Kitchin 2000).

In this article I develop additional critical perspectives on IT by focusing on the use of desktop computers in the academic workplace, the controversial emergence of computer-related repetitive strain injury (RSI), and the politics of disablement in university research. I describe how RSI can reposition some of IT's most ardent users from able-bodied to disabled worlds and identities; and in particular, how computer-related injuries can affect faculty and students in higher education.

I argue that bodies impaired by this condition can be understood, particularly in the context of university workplaces, as sites of contested and negotiated social identities and employee-institution power relations. From 'the field', I describe some personal experiences with RSI to suggest how such injuries subvert lived boundaries between workplace, home and other activity spaces. Because the experience of RSI can also reduce an individual's production of scholarly research, I also discuss problems of academic marginalisation and whether computer-avoiding scholars are even 'in place' or valued today in North American universities. The foregoing should indicate that I believe intensive keyboarding and gazing for hours into computer monitors can injure people: I assume an RSI advocacy rather than a neutral or pro-industry position.

This article is not intended as a latter-day Luddite critique of modernity and technology, although modernity is surely implicated in the explosive rise of computer culture. Despite IT's many benefits, computer use can be interpreted as a set of western capitalist cultural practices; often marketed by the media through images of progress, economic and social advancement, and elitist knowledge. Nor is this article a transparent ploy for sympathy in a classical 'personal tragedy theory' mode (sensu Oliver 1990, 25). Indeed, my personal situation is more privileged than that of most people who become injured through computer use, such as poorly paid data-entry workers, and certainly more privileged than that of people who cannot afford computers. Rather, I hope to develop a broader social critique.

Placing RSI in Disabilities Studies

Most critical researchers who study disabilities question how environments effectively disable or enable certain groups of people, and avoid defining disabilities as objective realities located within specific individuals (cf. Park, Radford and Vickers 1998; Gleeson 1999). Taking their line of inquiry a step further into the Information Age, there is no doubt that computers and software can positively and dramatically reduce socio-spatial barriers in places and difficulties in negotiating physical distance for persons with impairments (Golledge 1997, Gold 2000). Speech-recognition software, to cite just one example, can facilitate communication for people with difficulties in moving their hands. Through the Internet, individuals can choose whether or not to identify themselves as disabled to those with whom they communicate (Weir 2000; Sapey 2000; cf. Kitchin 1998b, 394-5), thus virtually resisting ablest stereotypes that devalue people with visible injuries and illnesses.

Yet the benefits of computing are not distributed evenly. Some historically marginalised groups who have difficulty in accessing computers, such as the poor, risk being sidelined or excluded from cyberspace; thus from global changes in communication that are as significant as the invention of the printing press and the Industrial Revolution. Despite important advances in adaptive technologies for persons with disabilities, disabled people seldom have managerial positions in the fields of computer and software design. Sapey (2000) argued that disabled people are under-represented in information-sector employment. Pearson (1995), Perry and Graber (1996) and Fountain (2000) found that North American women held fewer positions of authority as designers within the IT industry: and were over-represented among low-paid data-entry workers. Thus the expansion of IT in the workplace can reinforce pre-existing social inequalities.

While I have taken much inspiration from recent geographies of disability (such as Chouinard 1996, 1997; Chouinard and Grant 1995; Dear et al. 1997; Dyck 1999; Gleeson 1999; Golledge 1997; Hall, 2000; Kitchin 1998a; Park, Radford and Vickers 1998) my arguments regarding workplace injury and computing differs in some important ways from those publications. For example, disabilities scholars have criticised the 'medicalisation' of disabilities (and hence marginalisation of persons with disabilities from mainstream society) as ignoring the demands of wage labour under capitalism for 'able bodies' capable of serving industry as workers or consumers (Oliver 1990, 47; Gleeson 1999). Medical models of disability may also ignore ideologies and practices influencing architecture and urban design that result in, for example, steps and curbs that needlessly but effectively limit the mobility of people in wheelchairs.

People with RSIs, however, today may struggle to gain medical recognition for their condition in an attempt simply to access needed resources, like health benefits and workers compensation, that currently require medical authority to legitimate claims for assistance. I consequently worry that my discussion of RSI may not 'belong' in the disabilities literature at all, or worse yet; may misappropriate it.

As I hope to demonstrate, my project specifically responds to Parr and Butler's (1999, 9-10) interest in problemetising categories of dis/ability:
   We want to widen the scope of a "geography of disability"
   to consider all sorts of people, with all sorts of
   different mind and body characteristics--we are interested
   in multiple aspects of their lives: their pain, their
   everyday geographies, their struggles, their positions
   within capitalist wage-labour relationships, ... how
   social and physical environments are designed and
   built to exclude particular minds/bodies ...


The very idea of any particular impairment, moreover, develops through social processes of negotiation and contestation over a period of time and in particular places (cf. Arksey 1998; White 1991, 75-77). Criticisms (Oliver 1990, Gleeson 1999) of medicalised representations of disabled people frequently assume substantial tacit prior agreement as to what particular health conditions or impairments actually are and how they affect peoples' lives (e.g., cerebral palsy or amputations). Today computer users, manufacturers, lawyers, employers and doctors debate the possibility of actual or possible injury from extensive keyboarding and looking into video display terminals or units (VDTs or VDUs). Because the process of even naming or agreeing upon what constitutes evidence of computer-related RSI is still debated, discourses of health/illness and workplace safety are among the few literatures currently available with which to broach a discussion of RSI at all. Further because the whole issue of chronic pain (a major RSI symptom) today is mostly theorised by health care and behavioral scientists, medicine 'succeeds in cornering the market on knowledge of these phenomena' (Linton 1998, 529). Moon (1996, 114) specifically identifies computer-related cumulative trauma disorder (CTD) as a disability, while recognising that it may be temporary or restricted to particular tasks.

I hope therefore to expand the scope of the geographical study of disability, rather than to misappropriate it. Inadequate attention to the human costs of poor computing ergonomics potentially converts the office and university into places of marginalisation and civil risk (Kobayashi and Ray 2002) for people with RSI, while at the same time IT and RSI erase conventional distinctions between these places.

What is RSI? A Primer for Academics

Today computer-related injuries may be defined under a bewildering number of different terms together with their initials: I use the most widely-used and inclusive term, repetitive strain injury or RSI; while recognising other terms for specific injuries such as carpal tunnel syndrome, or other suitable types of inclusive terms like CTDs or musculoskeletal disorders (MSDs). (1) RSI in general refers to many types of injury with no relation to computers or particular occupations: it basically includes any tissue damage caused over time by repeated movements of the same parts of the body. Repetitive strain injury of all types currently comprises the greatest percentage of workers compensation claims cases in the United States and Canada (Kome 1998, 7-8; Walker 2000). Carpal tunnel syndrome, the most popularly recognised form of computer-related RSI, currently is the most frequently reported form of RSI in the United States, and the reason for the highest number of days away from work reported, according to the U.S. Bureau of Labor Statistics (www.bls.gov/ news.release/osh2.nr0.html).

Computer keyboards and pointing devices ('mice') require repeated use of the same small muscles of the hands and hence nerves and tendons of the wrists, potentially leading to RSI. Staring into a VDT for hours with the same body position can stress the spine, with repercussions for muscles of the back, shoulders and neck. Typical symptoms related to desktop computer use include painful muscles in the neck, shoulder and forearm. More serious complaints include chronic pain and permanent nerve damage to hands. As discussed in more depth below, RSI afflicts some people more than others and is by no means inevitable. Perhaps one-fifth of regular computer users experience some RSI symptoms (Pascarelli and Quilter 1994, vii).

A significant dilemma in explaining computer-related RSI is that it is currently very much in the process of being socially constructed, simultaneously by the medical profession, the courts, the IT industry and society at large (cf. White 1991, 75-76; Bammer and Martin 1993; McIntosh 1993; Arksey 1998; Mogensen 1996). Medical professionals disagree as to what computer-related RSI really is, how to treat it or even whether it is primarily a physical or psychosomatic condition. Few medical doctors specialise in occupational medicine, creating a situation whereby different types of specialists apply significantly different diagnoses and treatments according to their specialties. In lawsuits filed by affected employees versus their employers or versus computer manufacturers, judges disagree whether RSI is a legitimate medical disorder; and even if so, whether it meets their jurisdictions' precise legal definition of 'occupational disease.' (2) Thus RSI may 'exist' in one jurisdiction but not in another, for purposes of patients' lawsuits or compensation claims.

A consortium of computer companies including IBM and Microsoft, participate in a lobby group called the Office Ergonomics Research Committee (OERC), which favors the term 'upper extremity musculoskeletal disorders' (UEMSDs), over RSI, a label that rhetorically detaches physical symptoms from repetitive motions and thus rhetorically enables the consortium to dispute claims that muscle spasms or nerve damage are related to computer use (www.oerc.org/oerc.htm). As with any discursive construction of an impairment, terminology here is critical. A 'disorder' or even 'syndrome' is a neutral term, devoid of causality, liability, blame, or responsibility. 'Injury' presupposes a specific direct cause, often located in time and place (Arksey 1998, 19-20). Determining UEMSD or carpal tunnel syndrome as not caused in any particular time or place (unlike an injury) allows the 'where' and 'by whom' of disablement to remain indeterminate and disputable.

Of course, computer and software manufacturers as well as computer-intensive employers may have vested interests in obfuscating RSI as a medical condition caused by workstation designs or employer demands, and in blaming individual computer users for their own misfortunes. Corporations may define what it means to be a 'normal' computer-intensive worker in ways that promote and naturalise employers' and computer manufacturers' self-interests (cf. Oliver 1990, 53-54).

One strategy is to frame the discourse according to behavioral science models that are strongly based in traditional magisterial, non-interactive research methods that pre-empt patients' own perspectives. RSI complainants may be tested, counted, analysed and observed by experts; but are apparently seldom asked to help design the basic research or offer feedback on the conclusions, except in a few enlightened applied office re-designs (cf. Luczak, Cakir and Cakir 1993; Moon and Sauter 1996; Mogensen 1996; Williams 1995).

Some scholars sympathetic to industry's anti-RSI position have argued against accepting patients' reports of pain as valid evidence of injury. Keefe and Egert (1996, 164), for example, suggested that some CTD patients tend to 'learn' pain from a process 'in which disabled family members model pain and illness behaviors and reinforce these behaviors when they are displayed by the patient', suggesting their pain has no physical basis. They describe long-term pain sufferers in basically pejorative or moralistic terms, despite their article's scientific coating. People experiencing pain may 'develop significant behavioral problems', engage in 'overly negative thinking', display 'learned patterns of maladaptive responding', 'problematic behavior patterns', or 'maladaptive beliefs'. The purpose of cognitive behavioral intervention is to fix the individual's 'maladaptive pain beliefs' and to 'divert and distract their attention away from pain'. Thus in situating pain sufferers socially through demeaning language, nowhere do the authors consider workplace power relations, badly designed workstations or potential benefits of engaging their research subjects in the research design. The authors' goal is apparently to reify and fix malingering through cognitive-behavioral interventions (Keefe and Egert 1996).

Of course pain, like other experiences, is embedded in social discourses and differences. For example, most cultures teach boys that it is not manly to experience or acknowledge feelings of pain. My concern here, however, is with how RSI research can be deployed to reproduce and reinforce unequal power relations between employees with RSI and their employers or the IT industry by controlling the discourse in ways that trivialise people already in danger of becoming marginalised in an ablest and technophile society. For example, the director of another lobby group of computer-intensive companies, called the Center for Office Technology (COT) (www.cot.org), dismissed RSI as 'the popular illness of the day', reducing it to the level of a fad. (3)

The limited data derived from scientific RSI studies may be interpreted to the industry's advantage (cf. McIntosh 1993, 511 footnote 1). For example, IBM's 'Healthy Computing Website' (www.pc.ibm.com/ ww/healthycomputing/index.html/) has an archive of RSI-related news items, mostly arguing that the links between computer-linked health issues and office computer use lack scientific proof. While the implication of such arguments is that computers are therefore perfectly safe; the disclaimers may equally be read as acknowledging that the large-scale, in-depth studies that medical scientists demand before they draw firm conclusions, have yet to be conducted. 'There is no evidence that ...' may translate as, 'data have not been collected' or as 'no one has undertaken adequate research'.

Corporate discourses about RSI may also interpret the research data that have been published to date to suit corporate agendas. For example, COT argued that recent U.S. Bureau of Labor statistics demonstrated that 'these incidences [of RSI] are not the growing menace reported in the media,' based on declining numbers of lost work days due to RSI in recent years. The Bureau of Labor did not purport to measure all RSI cases reported, however; such as RSI patients who went to work despite their condition.

The relatively low and declining numbers of Bureau of Labor reports on computer-related RSI (compared with, say, numbers of RSI cases among factory or farm workers) allowed COT to trivialise RSI. However, their interpretation that better workplace ergonomics have mitigated office workers' musculoskeletal complaints actually gives indirect and tacit confirmation that RSI exists. COT implied a media-driven moral panic about RSI, yet newspaper reporters who word-process their articles under high-pressure deadlines are particularly susceptible to RSI (Fine 1996, 295); and major newspapers, who invested early and heavily in computerised writing and printing, are among the lobby consortiums' members (Kome 1998, www.oerc.org/oerc.htm; www.cot.org).

Lobby organisations may also ignore studies that contest their position. For example, ergonomics journals have begun to publish computer-related RSI investigations concluding that injuries or at least significant discomfort indeed occurred among populations studied (cf. Amell and Kumar 1999, Harris and Straker 2000, Wilson 2001). These were not part of the above cited computer lobbies' web site archives at the time I consulted them.

Information Technology lobby groups also sponsor research and symposia sympathetic to their position that musculoskeletal disorders among computer workers are psychosocial in origin; rather than, say, a product liability issue for computer manufacturers or a workplace safety issue for employers (Moon and Sauter 1996, xix). One behavioural science study in an OERC-sponsored symposium (Skelton 1996) indeed specifically tested and validated the pro-industry proposition that RSI complainants lose credibility with the public to the extent that their RSI can be rhetorically linked to non-physical, psychosocial variables such as the complainants' level of stress on the job.

Ironically, as industry groups like IBM, the COT and OERC seek to de-medicalise RSI, they approve of research that places musculoskeletal disorders within a broader social context. But theirs is no postmodern or patients' rights agenda. It is, rather, to shift attention away from employers' and industry's own practices and to locate RSI squarely in the individual worker's own subject positions--indeed, in her flawed body or 'in her head' (of. Moon 1996, 120; MacEachen 2000).

Discourse may also be controlled through more overt political means. Press releases by IBM and COT on their web sites indicate how they lobbied against standards proposed by the U.S. Office of Safety and Health Administration (OSHA) that were intended to include computer-related RSI. The lobbyists argued that too little is known about computer-linked musculoskeletal disorders, and that industry cannot be held responsible for a problem essentially related to individuals' idiosyncrasies, described below.

Embodying RSI

Because there are so many unexplained individual differences in why some computer users get RSI and others do not, one cannot argue that regular desk- or laptop computer use will inevitably cause RSI. RSI seems most likely to affect individuals with round shoulders, excess weight, bifocals, thin wrists, double-jointed fingers, psychological stress, pre-existing health conditions like diabetes or arthritis, little independence on the job, a monotonous job, short stature, pregnancy, a smoking habit, a sedentary lifestyle and/or weak muscle tone. Typists who strike the keyboard keys harder than necessary are characterised as at fault for their 'individual work style' (OERC Inc. 1997). Sometimes computer users' hobbies are blamed, such as knitting or practicing a musical instrument, as these also require repetitious finger movements (www.cot.org). (4) There is consequently an industry tendency to blame the afflicted for their own difficulties, to narrow the definition of normal bodies and activities (e.g., to exclude slender wrists) or to attribute RSI to personal habits or genes beyond the computer providers' control; rather than to criticise employers or manufacturers for failing to provide workstations suitable for a typical range of actual human bodies and experiences (cf. web.mit.edu/atic/www/rsi/mitrsi.htm, www.oerc.org/oercl.htm, www.cot.org). The individualisation of RSI means that RSI-related product liability lawsuits seldom succeed, apparently because juries accept the industry's defence that computing products or office ergonomics were not entirely to blame for litigants' health problems.

As someone with computer-related RSI, I question the industry's logic, however. I have spent my entire life with thin wrists and round shoulders, without experiencing any muscle spasms or nerve damage symptoms prior to intensive computer use. I am 'normally' healthy and able-bodied. I view extended computer use as the trigger for my symptoms, if not necessarily the sole cause. My reaction is apparently typical of people with computer-related RSI (Arksey 1998, 2, 127). Our formerly 'normal' bodies, however unique, are now the individualised and personalised authors of our own misfortunes, according to industry logic.

Thus rhetoric means a great deal when it comes to understanding the causes and consequences of RSI: who controls the discourse controls the power relations. The battle over representation has the electronic information industry actively attempting to de-medicalise RSI, to attribute it to psychosomatic causes, and to trivialise a low number of incidents. At the same time people who have RSI struggle to gain medical recognition for it as a work-related physical injury and to have its incidents documented more comprehensively, often simply in order to qualify for treatment for it under their health insurance plans or workers compensation programs.

Fixing RSI

A variety of types of help and information on RSI are available, but they can be problematic. Medical doctors' knowledge of and sympathies toward computer-related RSI vary widely (Arksey 1998). The invasive medical treatments of even a few years ago (such as wrist surgery or cortisone injections) are basically ineffective so long as people return to the same repetitive movements that injured their bodies in the first place. (My doctor prescribed anti-inflammatory drugs, pain killers, physiotherapy and acupuncture--none of which had long-term benefits.) A few commercially published self-help books are available (Pascarelli and Quilter 1994, Peterson and Patten 1995), as well as several volumes (often privately published) on alternative therapies. Several provincial agencies in Canada publish booklets and Internet sites on how to improve office ergonomics (Alberta 1993, Occupational Health 1997).

Most of the information on RSI for the layperson is available on the World Wide Web. (5) So ironically people with RSI must use the computer even to find out how to mitigate its negative health effects.

These sites reveal universities' involvement with RSI. One of the best websites on computer-related RSI was the 'Harvard RSI Action Home Page' prepared by and for students at Harvard University (www.rsi.deas.harvard.edu). A site by the Massachusetts Institute of Technology for its students and employees reported 300 RSI cases in 1996 (web.mit.edu/atic/www/rsi/absolutely/absolutely. htm). A study by Peper and Gibney (1998) posted on the FAQ Typing Injury Website reported that 96.8 percent of a sample of students interviewed at San Francisco State University reported some physical discomfort associated with computer use. Their sample students used computers for an average of 2.9 hours per day (www.ctdrn.org/). RSI, then, is not a problem restricted to middle-aged clerical workers with two decades of data-entry experience. What troubles me about the university sites is their evidence that RSI affects some of the brightest, most computer-literate of American students.

Employers, safety agencies, and labor unions print 'solutions' in the form of various memos, booklets and workplace safety posters for their clerical workers. It is fair to say that most of the helpful tips for curing RSI also locate the disease in the worker's body and put the burden on the employee to fix her own problem by sitting up straight. They tend not to assign responsibility to the employer who determines the work assignments and buys the office furniture and equipment, nor to computer hardware designers who plan the screens and keyboards. Although federal and provincial or state workplace safety legislation place the burden of correcting unhealthy working conditions on the employer, power differentials between employers and employees often mean that the latter hesitate to complain. (6) VDT workers often report off-record that they fear losing privileges, promotions or even their positions if they report poor ergonomics (Kome 1998, Mogensen 1996). (7)

Most of the institutions' remedies for computer-linked RSI urge computer-users to maintain a specific posture while word-processing. An idealised, universal and typically smiling cartoon office worker is sometimes depicted in 'how to' illustrations of proper posture. For example, the artist's figure developed by the Occupational Health Clinics for Ontario Workers Inc. (1998) is sufficiently long-waisted so that her torso is just the right height for her office desk and chair; her arms and wrists can be held comfortably at precise right angles. Her legs are long enough to reach the floor once her chair is high enough so that she can hold her arms at an exact right angle at the keyboard. Graphics of male computer-users sometimes show even more stylised, faceless android or robot-like figures (cf. IBM and MIT websites). One early manual prepared for the state of Wisconsin (Sauter 1985) was loaded with photographs of actual people caught on camera showing poor computer posture, whereas only two photographs (but numerous artists' drawings) showed correct computing positions.

Perhaps it is not coincidental that most of the representations I have seen of correct computing posture are artists' renditions, or even cartoons, rather than photographs of actual people. Real people working on real desktop computers abound in office buildings, universities, on television news programs and (as actors) in advertisements, and in their homes. Few of them--even the actors in commercials--display the ideal computing posture because a single position, no matter how ideal from the perspective of employers and manufacturers, cannot be easily maintained by the entire range of 'normal' human bodies, especially not for long periods.

Few desktop computer workstations are actually designed and set up to support correct posture: older desks were designed to support handwriting. The common fixed height of a desk 'properly accommodates only a very small portion of the work force who use computers as their primary work tool' (www.oerc.org/oerc.htm, sec. 5). Many workstations cannot be adjusted to meet individual needs. Some are terminals in undergraduate computer labs and are used by a range of short and tall students on any given day. Family members with vastly different body heights and habits may share a single home computer. Take away the cartoon workers' desktop keyboard and monitor and give them a laptop for office, travels or research field work; have them word-process for an average of three or more hours per day over a course of several years, and there is no way even cartoon figures can maintain the proper separation between keyboard and screen to maintain correct posture; nor avoid cramps in the back of their necks (Wilson 2001).

Human bodies that evolved by the Paleolithic were adapted to move and change position frequently. Holding one's hands and arms all day in the correct position to reduce wrist strain actually puts extra stress on one's back and neck. By the industry's own admission, an optimum position for one body part may have a negative impact on another body part, turning the body/workstation interface into an unsolvable Rubik's cube (cf. www.oerc.org/oerc.htm, secs. 4.2, 5). Indeed, if one sums up all of the individual body types and personal habits deemed by industry lobbyists to be at high risk for RSI (overweight, stressed out, stoop-shouldered and so on) probably only a minority of computer users are well matched to their workstations.

Beyond the office, many scholars use computers at home, in libraries or during their travels, which problematises ascribing RSI solely to one's main workplace. There is almost no information available on the safe ergonomics for laptop or portable notebook computers, even according to the industry's own OERC (www.oerc.org/portable.htm). I invite readers to demonstrate how one could reconfigure employers' posture posters with actual human beings working with the designs of laptops or powerbooks on the market at the time of this writing, due to the lack of separation of keyboard and screen (Wilson 2001).

Employers and regulatory agencies who recognise workstation ergonomic problems may counsel their clerical workers to take brief stretch breaks. (8) For example, the Ontario Occupational Health and Safety Act (1992) obligates employers to give VDT workers a five-minute stretch-break for each hour of continuous computer use, although the health benefits are unproven (anon. 1999). My employer, however, notified me of its obligations under the Ontario legislation via a small anonymously authored poster placed in my departmental mail room in the summer of 2000; eight years after passage of the legislation. The poster itself implies only that five-minute breaks are a smart idea, not that they are VDT workers' rights by provincial law.

The cynical interpretation of this weak depiction of employer obligations and employee rights, unfortunately, is another low-cost downloading of responsibility from the employer and manufacturer to the individual worker; particularly where workloads do not down-size sufficiently to permit pain-free word-processing. While my employer advises me via a mail room poster to get up and stretch, it does not simultaneously advise computer designers to develop more body-friendly equipment.

Williams (1988) urged employers to engage office employees in redesigning more body-friendly workstations, management-employee relations, and allocation of office tasks. One decade later, Smith (1997) made a similar plea, noting that holistic approaches were seldom applied to office design. COT and OERC also support rethinking the entire office environment, according to their websites. While strongly endorsing holistic solutions, I suspect that the lobbyists' emphasis on inter-personal relationships in the office hierarchy rather than on, say, poorly designed VDTs or high-pressure workloads, is indeed consistent with the lobby groups' simultaneous denial of RSI as a product design problem in their political and public relations positions.

Technological solutions like voice-activated software may reduce strain on one's arms while exacerbating it in one's neck or vocal chords; as the many errors in today's newly emerging voice-recognition word-processing systems require longer time at the computer monitor to produce the same output of accurate text for individuals proficient in rapid touch-typing. Voice-activated software is problematic in shared offices within earshot of other people. Many new ergonomic products are on the market such as 'split' keyboards, but few of them have been independently tested for efficacy. Thus technical fixes are only promising.

A critical issue for academics is not only that the personal intensity and duration of our work differs from that of most nine-to-five clerical workers, hut that often we are not workers in the usual sense (cf. Chouinard 1996, Golledge 1997, Moss 1999 on disabled geographers' issues). Professors, academic support staff and graduate assistants who are unionised have at least the potential to insert health-protective clauses into their employment contracts. These can be more difficult to negotiate and enforce, however, in institutions with nonunion 'special plans', where faculty association advocates and administration-appointed grievance committees are likely to be 'well-meaning amateurs' with no background in ergonomics or employment legislation.

Unless they are also teaching or research assistants, most students are not employees at all, and have no rights under workers compensation legislation. Partial health coverage can be particularly troubling to graduate students in the throes of serious thesis-typing; because (depending on their jurisdiction) conventional RSI treatments like anti-inflammatory drugs, physical therapy or acupuncture may not be covered by their health insurance programs. Self-employed or independent scholars face similar difficulties. In Canada, for example, universal provincial health care pays for doctor appointments, but not for medications, physical therapies or other treatments. These may be covered for individuals on workers compensation or with supplementary health plans offered by employers. Graduate students spending long hours word-processing their theses would seem to be particularly disadvantaged. Even professors with full health benefits may find themselves in murky waters in seeking RSI compensation if it can be shown that they used their computer extensively in off-campus sites, such as the home, where the employers' duty to provide an ergonomic work environment is doubtful.

A Cautionary Tale

My own initiation to RSI began in 1993 when I experienced tingling, numbness and hot-and-cold sensations in my hands, together with pain and muscle spasms in my lower arms and wrists. I was then a professor and dean of my small faculty at the University of Waterloo. Years ago as a high school student, I had learned to touch-type rapidly for long periods, and had word-processed most of my own academic work for about a decade. Hospital tests in 1993 for nerve damage proved inconclusive. Fortunately I had sufficient available office support to delegate much of my word-processing to a highly capable staff member, and to simply and voluntarily reduce my computer use. In 1997 I began a two-year sabbatical and research leave with minimal secretarial assistance, but with strong internalised pressure to write as much as possible. I did most of this work on a laptop computer in libraries, sabbatical accommodations and at home, all without ergonomic furniture. By 1998 the former symptoms returned, exacerbated by muscle spasms in my neck and shoulders. These symptoms persisted on days when I did not use the computer. Non-computer activities that required grasping something tightly, flexing my wrists or lifting my arms for more than a moment became painful. These included carrying a briefcase full of books, shoveling snow, pushing a shopping cart, opening a heavy door, driving to work with hands on the 'ten to two' position on the steering wheel and writing above chest-level on a classroom chalk board.

Rather than finding the 'disembodied' freedom-producing, cyborg-like identity in computing as envisioned by some futurists (Graham 1998), word-processing had made my own body all too tangible and limiting. Never mind sophisticated theorising about bodies as representational or politicised: this stuff hurt in real time (cf. Hall 2000). The very aspects of academic life most central to my vocation--research and writing--had become disabling.

Before long, I had a doctor's note in my university personnel files that advised no further keyboarding, and I was on workers compensation to cover the costs of weekly physical therapy. I also needed a more ergonomically sound office workstation but no one in my department or faculty appeared to have any funds for such a purpose (neither they nor I realised at the time that the senior university administration was the employer with the duty to accommodate my needs under the Ontario Human Rights Code). My university's health and safety officer got me an ergonomic office chair and desk wrist pad from Central Stores but my spouse paid out-of-pocket for a new computer with a state-of-the-art ergonomic keyboard and voice-activated software that unfortunately proved to be far slower and more inaccurate than my normal typing. (9) I learned through conversation with the health and safety officer that he had had wrist surgery to alleviate his RSI.

Physiotherapy probably helped the muscle spasms, but it had its troubling aspects; namely in its purpose of sending patients back to work as fully and quickly as possible: that is back to the same conditions that injured them in the first place, and that would re-injure them if nothing in the workplace changed. The 'problem' of rehabilitation is thus reinscribed within the injured individual, not in the practices of workplace or the purveyors of its products like desktop computers. Moreover, I learned through chatting with my physical therapist that her profession is particularly prone to its own types of RSIs: namely excessive strain to their backs and hands. Since she worked on a part-time basis there would be no employer benefits coverage for any physical therapy she might eventually require as a result of helping patients like myself with their RSI problems.

Another problem (albeit one that reified my privilege compared with most people with RSI) concerned my difficulty, once back in my department as a regular faculty member, in obtaining the kind of secretarial support for research manuscript typing that professors 20 years ago routinely took for granted. None of our departmental office staff by 1998 had contractual job descriptions that listed word-processing faculty manuscripts: their typing for me was essentially an overload that interfered with their assigned administrative support duties. The change in staff duties essentially acknowledged that most professors today word-process their own work. Initially my department chair attributed my request for extra staff support to the belief that I was still writing out manuscripts in long hand. When I produced a doctor's note verifying RSI and got on workers compensation, he became sympathetic, but uncertain as to how the department might help, given its shrunken budget and staff limitations. Then began a tense period in which I essentially re-negotiated my former able-bodied identity in order to produce my research. Reminding my chair that the department had an obligation to accommodate my needs 'up to the point of undue hardship' (as per Human Rights Code precedents) did not resolve the word-processing problems: it only meant that the most junior staff member in the department was permitted to work on my book manuscript in her 'spare time' when she was not busy with her regular assigned responsibilities. Consequently months would pass while my manuscript languished by her desk. Alternatively when I protested loudly enough to the chair, she would work on my manuscript but then had to let her own normal duties slide.

I worried that keyboarding a large book manuscript would give this staff member a case of RSI, as well. The staff member's more realistic concern was that the departmental administrative assistant who conducted her annual merit evaluation would evaluate her performance based simply on the duties listed in her job description--which she could not manage so well under the extra burden of my 400-page manuscript. I tried to be considerate and sent the staff member flowers on Secretaries Week, but these hardly touched the fundamental problem: a class struggle writ small. Our dilemma improved only near the end of 1999 when the dean assigned his own administrative assistant/personal secretary to help with my word-processing. This was a decision few deans would probably care to make; and perhaps a resolution that few less assertive or less senior professors would try to obtain. This incident underlines the ad hocery and dependency on goodwill that characterises disabilities accommodation.

A second anecdote concerns a phone call to my case worker at the Ontario Workplace Safety and Insurance Board (WSIB) office in January 1999. Frustrated with the above impasse, I simply wanted to know my rights and my employer's obligations, and asked her how I could obtain a copy of the pertinent regulations. There were no manuals or lists of regulations available at the WSIB office according to the case worker, not even under the Freedom of Information Act. Even after I explained that my doctor's certificate said 'no keyboarding' she simply told me to ask my employer for a better work station. Reacting badly to this advice, I asked the case worker whether she had ever had RSI from computers. 'We all have it here!' she replied. Chastened, I suggested that she and her co-workers at the WSIB should themselves apply for workers compensation for their employment-related injuries. I do not know whether they ever did.

As a privileged university professor, I have yet to address the more serious RSI problems faced by low-paid clerical staff, particularly those working overseas in data-entry jobs, without health care benefits or job security. (e.g., Kasl, Amick and Benjamin 1996; Kome 1998, xii; Kitchin 1998b, 387; Pearson 1995; Ng and Yong 1999).

There is also the broader philosophical question (Perry and Graber 1996) about the extent to which computer technology itself, with its links to the industry's global economics (described by Kitchin 1998b) can be described as masculinist. Are 'malestream' values implicated in alarming rates of RSI among poorly paid female clerical workers, for example? As I fretted in 1998-99 over a female secretary's difficulties in transcribing my research manuscript, was it not because I had internalised a career path initially designed by and for middle-class men to perpetuate universities as hegemonic patriarchal structures--and that women faculty have joined but scarcely altered? As a voluntary consumer of computer hardware and software, as a shareholder in IT companies via my university pension plans and as a professor who may derive professional benefits from this word-processed paper, can I claim any innocence or victimisation? I think not.

Conclusions

As computers become increasingly naturalised in collegial communications, teaching, research and service activities, pressures to use them more often are likely to intensify. Students and faculty increasingly view professors as dated if they do not post course materials on the web. Web-based courses and PowerPoint presentations are standard fare for conference presentations and, increasingly, for classroom teaching. Listservs and e-mail are the normal communication venues among scholars with similar interests. Co-authors and co-investigators routinely conduct joint research and prepare publications via e-mail. Participation in North American scholarly geography meetings virtually requires computer use in order to submit an abstract, register, acquire the conference program and/or prepare a paper for a discussant. Most geography journals and book publishers require texts to be submitted electronically. Within 20 years, the information highway has gone from being an enticing alternative route to a one-way street of normal academic life (cf. Sheppard 1993, 459). Academicians no longer have exit ramps along the information highway (cf. Graham 1996, 384).

While the information age is arguably emancipatory for most scholars (not counting floods of unproductive e-mail), RSI patients risk institutional disablement and marginalisation from academic life. Preparing papers (like this one) exacerbates their symptoms. Kitchin's (1998a, 349-50) assessment of disability and space might equally theorise the situation of people with RSI in academic life:
   Who is felt to belong or not belong in a place has important
   implications for the shaping of social space ... We
   live and interact in spaces that are ascribed meaning
   and convey meaning... Spatial structures and places
   within the landscape provide a set of cultural signifiers
   that tell us if we are "out of place" ... Social relationships
   are mediated through a variety of socio-spatial
   processes and space is produced in such a way as to
   maintain current power relations.


In today's university, knowledge and access to IT confer power. Because resistance to the computerisation of academia has so far originated primarily from older technophobe faculty relegated to the status of 'out-dated', technologically incompetent, or personally unfortunate; the politics of electronic marginalisation have yet to be seriously contested.

Computer-related RSI experiences abound in universities, but there are few systematic published data on incidents at any scale. (10) Few individuals ask the most foundational questions, such as whether standard office computer equipment in the context of some peoples' bodies and livelihoods is not or perhaps cannot be made healthy for them. In an era when ever more sophisticated hard- and software are seen as the inevitable and greatly desired future--and even as the new Industrial Revolution--a suggestion seriously to rethink computer-use may well be radical, but instead it sounds like a technophobic reactionary alarm.

I would like to reassure readers that a critique of computer-related RSI by no means ignores the real benefits of adaptive technologies for many people with disabilities. Nor do I disparage the significant benefits of computers to society and university life; benefits that I have shared.

The extent to which major computer and software manufacturers have sought to discredit RSI and to ascribe it to individual computer-users' idiosyncrasies however, indicates the unequal power relations of current contests about RSI. I am bothered that high-tech executives make their millions from computer hardware and software sales while geography graduate students of my acquaintance struggle with low incomes, limited health-care benefits, intensive thesis word-processing and RSI.

Calls for more socially concerned studies of computers in society are cogent (Haraway 1991, Perry and Graber 1996). One issue is insuring equal on-ramps to the information highway, especially for persons with disabilities who would welcome such access. But another social issue is insuring that people already traveling the Information Highway do not get wrecked or disabled along the road. With more travelers touring cyberspace at younger ages (in affluent families, often as soon as children are big enough to reach the keyboard) society as a whole must question, as it does for material highways and automobiles, how many injuries it will tolerate, how to prevent them and how to balance individual, government and corporate responsibility in preventing injuries in the first place. The answers may play out differently for different people, depending on such variables as type of employment and even their individual bodies interacting with specific computer equipment. Because of their heavy reliance on word-processing for their livelihoods, however, the cautionary signs for scholars are already posted along the way.

Acknowledgements

Thanks are due to Valorie Crooks, Vera Chouinard, Pierre Filion, Rhiannon Bury, Phil Howarth and two anonymous referees for their critical advice on this paper.

(1) Other names include WMSDs or work-related musculoskeletal disorders, occupational over-use syndrome (OOS), etc.

(2) Bates v. Marine Midland Bank, New York Supreme Court, Appellate Division, No. 82103, 24 December 1998, cited in the New York Workers' Compensation Law Reporter 99 NYCLR 2007, as posted in the FAQ website, www.tifaq.org/information/ archive/nycourt_on_ctd.html. Site viewed October 2000. All websites were viewed in May, October, and November 2000 through 2002. Contents of webpages cannot be confirmed after these dates.

(3) This website introduction was viewed in May 1999. It was subsequently changed.

(4) COT "Comments on 29 CFR part 1910, Ergonomics Program, Docket S-77, U.S. Dept. of Labor," 23 February 2000.

(5) See, for example: CTD Resource Network, Inc., 'FAQ Typing Injury', http://www.ctdrn.org/; 'The RSI Network', http:// www.ctdrn.org/rsinet.html; IBM, 'IBM Healthy Computing Website', http:www.pc.ibm.com/us/healthycomputing/; MIT, mit.edu.atic/www/rsi/mitrsi.htm, Marxhausen, P. 'RSI Resources at UN-L', http://eeshop.unl.edu/rsiunl.html, viewed October 2002.

(6) In Canada legislation may be found under the Canada Labour Code or under the Occupational Health and Safety Acts of various provincial Workers' Compensation Boards. For a British Columbia example, see BC Regulation 296/7.

(7) This problem emerged strongly among participants at a workshop sponsored by the Staff Association and the Guelph & District Labour Council at the University of Guelph in Guelph, Ontario on International RSI Awareness Day, 29 February 2000.

(8) In Canada today, section 24 of the 1992 Health and Safety Act requires employers to give each worker at a video display terminal' a minimum of five minutes per hour for other duties or to take a break. (OHCOWI 1997).

(9) Ergonomic computing hardware is increasingly available, but the benefits to users, especially long-term health benefits, have yet to be assessed.

(10) Computer-related RSI injuries are seldom disaggregated from other types of RSI injuries such as assembly-line work, and workers compensation boards report only the more serious cases resulting in lost days of work.

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JEANNE KAY GUELKE

Department of Geography, University of Waterloo, Waterloo, Ontario, Canada N2 L 3GI (e-mail: jkg@fes.uwaterloo.ca)
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