Work 45 (2013) 213–221 213

DOI 10.3233/WOR-131603
IOS Press

Reliability and concurrent validity of the

Ccomputer Workstation Checklist
Nancy A. Bakera,∗ , Heather Livengooda and Karen Jacobsb
a
Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
b
Department of Occupational Therapy, Boston University, Boston, MA, USA

Received 5 November 2012

Accepted 17 January 2013

Abstract.
BACKGROUND: Self-report checklists are used to assess computer workstation set up, typically by workers not trained in
ergonomic assessment or checklist interpretation. Though many checklists exist, few have been evaluated for reliability and
validity.
OBJECTIVE: This study examined reliability and validity of the Computer Workstation Checklist (CWC) to identify mis-
matches between workers’ self-reported workstation problems.
METHODS: The CWC was completed at baseline and at 1 month to establish reliability. Validity was determined with CWC
baseline data compared to an onsite workstation evaluation conducted by an expert in computer workstation assessment.
RESULTS: Reliability ranged from fair to near perfect (prevalence-adjusted bias-adjusted kappa, 0.38–0.93); items with the
strongest agreement were related to the input device, monitor, computer table, and document holder. The CWC had greater
specificity (11 of 16 items) than sensitivity (3 of 16 items). The positive predictive value was greater than the negative predictive
value for all questions.
CONCLUSION: The CWC has strong reliability. Sensitivity and specificity suggested workers often indicated no problems with
workstation setup when problems existed. The evidence suggests that while the CWC may not be valid when used alone, it may
be a suitable adjunct to an ergonomic assessment completed by professionals.

Keywords: Ergonomics, workplace, psychometrics

1. Introduction operators do not have access to an ergonomics expert

and have to rely on self-assessment or untrained per-
There are many methods to assess the ergonomics sonnel to identify problems and solutions.
of computer workstations: from simple, self-report There are many checklists and online sites that pro-
checklists to comprehensive evaluations with sophisti- vide the basics of ergonomic assessment which can
cated equipment. The most effective approach for con- be used by computer operators to complete this self-
ducting an assessment of a computer workstation is an assessment [1–4]. These checklists generally evaluate
onsite, face-to-face evaluation by a professional trained the overall workstation, chair, keyboard, input device,
in ergonomic evaluation. Ergonomic experts often use monitor, environmental factors, and work habits. Un-
a checklist to make sure that all potential issues have fortunately, self-assessment using a checklist may not
been addressed. However, in many cases, computer be adequate to help untrained personnel identify work-
station risks and methods to reduce them [5,6]. Com-
∗ Corresponding author: Nancy A. Baker, 5012 Forbes Tower, puter operators may not be able to correctly identify
University of Pittsburgh, Pittsburgh, PA 15260, USA. Tel.: +1 412 risky postures, particularly as people with pain or dis-
383 6607; Fax: +1 412 383 6613; E-mail: [email protected]. orders may have decreased position sense [7,8]. Com-

1051-9815/13/$27.50 
c 2013 – IOS Press and the authors. All rights reserved
214 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist

Table 1
puter operators may not be able to identify the appro- Areas assessed by the computer workstation checklist
priate workstation changes, such as whether to repo-
Total number of questions
sition existing equipment or buy new equipment [5,
Computer equipment 5
9]. In addition, computer operators may be unaware of Overall workstation problems 4
resources to obtain new equipment, or of legislations, Chair evaluation 31
such as the Americans with Disability Act, that can be Keyboard evaluation 11
used to assist with obtaining reasonable accommoda- Input device evaluation 9
Monitor evaluation 7
tions [10]. Computer table evaluation 8
Another reason that self-assessment using a check- Document holder evaluation 3
list may not be effective is, although there are numer- Environmental factors 6
Work habits evaluation 3
ous computer workstation self-report forms available,
very few have been psychometrically evaluated to de-
termine if their results are reliable, and more impor- scale where 0 was no pain and 10 the worst possible
tantly, valid measures of workstation setup. An excep- pain. Respondents were excluded if they had a recent
tion to this is the validated office ergonomics checklist history of upper extremity musculoskeletal injury with
(i.e., the Computer Use Checklist) created by Janowitz current symptoms or had a rheumatic disorder such as
and colleagues [11] which primarily focuses on work- rheumatoid arthritis or fibromyalgia.
ing postures and movement patterns rather than risk
factors. Psychometric testing indicated that the Com- 2.2. Instrument
puter Use Checklist was only reliable when adminis-
tered by an ergonomics expert and not when used as a 2.2.1. Computer Workstation Checklist (CWC)
self-assessment by untrained workers. It also demon- The CWC is an 87-item self-report checklist. The
strated only limited validity identifying those with CWC was based on the Creating the Ideal Com-
musculoskeletal pain [12]. There is a need for reliable puter Workstation: A Step-by-Step Guide (Guide) [4].
and valid measures that help computer operators self- Since 2000, the Guide has been extensively used by
identify risks. researchers in their clinical practices in ergonomics.
The purpose of this study was to examine the However, over time it has become apparent that the
psychometrics of the Computer Workstation Check- Guide was missing some important questions related
list (CWC), a self-report checklist designed to iden- to computer workstation issues. The CWC was devel-
tify computer workstation items that need adjustment. oped to address these missing aspects and to increase
In this study, we examined the test-retest reliability the comprehensiveness of the evaluation. The CWC as-
and the concurrent criterion validity of key diagnostic sesses the following areas of the computer worksta-
questions of the CWC by comparing the results of re- tion: overall workstation, chair, keyboard, input device,
spondents’ self-reports of workstation problems using monitor, environmental factors, and work habits (Ta-
the CWC to the results of an evaluation of the computer ble 1). In each area, respondents are asked to consider
workstation by an expert in ergonomic assessment. currently available equipment and whether the equip-
ment is configured to match their personal specifica-
tions. The overall workstation items address relative
2. Method space and the type of available equipment (e.g., a docu-
ment holder and adjustable table). Chair items include
Data for this study was collected as part of a par- the adjustability of the controls, the chair height, seat
ent study which examined the effect of an ergonomic length and width, padding, the presence and position
workstation setup on musculoskeletal discomfort. of a backrest and armrests, and the type of chair base.
Keyboard items address keyboard placement relative to
2.1. Respondents other workstation equipment and space, respondents’
body postures, comfort, and the stability of the work
Respondents were recruited at the University of surface. Input device items include placement of the
Pittsburgh. The inclusion criteria were: working aged input device relative to workstation equipment, avail-
adults (18–65 years); used a computer at work for at able space, and respondents’ body postures, comfort of
least 20 hours weekly; and had experienced muscu- the input device, ease of use, and stability of the work
loskeletal symptoms of at least 2 on a numerical rating surface. Monitor items include adjustability and posi-
 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist 215

tion (e.g., height and distance) and visual needs (e.g., 2.4. Statistical analyses
whether respondents wear bifocals or trifocals and the
clarity of images or size of text for reading ease). Fi- Statistical analyses were completed using SPSS
nally, respondents rate environmental factors that may (version 19.0). The kappa coefficient was used to as-
affect their performance such as noise, room tempera- sess reliability as the data were dichotomous and nom-
ture, and glare. Respondents also consider work habits inal [13]. The magnitude of the kappa coefficient is in-
such as frequency of breaks and changes in body posi- fluenced by both prevalence and bias. When the dis-
tion. tribution between concordant cells in the 2 × 2 table
The checklist is dichotomous (yes/no) except for is disproportionately unbalanced, the prevalence pro-
computer equipment specifications. When responses portion is large and results in an underestimated kappa
coefficient. When the distribution between discordant
are “no”, these answers indicate potential problem ar-
cells is disproportionately unbalanced, the bias propor-
eas.
tion is large and results in an overestimated kappa co-
efficient. Due to the imbalance in our data between
2.3. Procedure high and low distribution of counts related to preva-
lence and bias, the prevalence-adjusted bias-adjusted
The study was approved by the University of Pitts- kappa (PABAK) was used to ensure accurate results.
burgh Institutional Review Board and respondent con- The PABAK adjusts the average of counts between
sent was obtained prior to assessment. To determine the concordant and discordant squares to minimize the
test-retest reliability, respondents completed the CWC influence of prevalence and bias [13]. The following
during their baseline assessment during the parent scale was used to interpret the strength of the agree-
study and again 1 month later. We anticipated that the ment using the kappa coefficient:  0 = poor, 0.01–
1 month interval between CWC completions should be 0.20 = slight, 0.21–0.40 = fair, 0.41–0.60 = moder-
sufficient to minimize memory bias. Both assessments ate, 0.61–0.80 = substantial, and 0.81–1.0 = almost
were completed online using SurveyMonkeyTM. No perfect [13].
intervention or feedback regarding the workstation Sensitivity, the proportion of responses in which the
setup was provided between the two assessment time CWC correctly identified problems when they existed,
points. and specificity, the proportion of responses in which
Criterion validity was assessed to establish how the CWC correctly identified no problems when no
well the CWC identified mismatches between worksta- problems existed, were calculated to determine valid-
tion configurations and self-perceived positions of the ity. Positive predictive value (PPV), the probability a
workers. Specifically, the CWC data obtained at base- workstation had a problem area when the CWC iden-
line was compared with onsite workstation evaluations tified a problem area, and negative predictive value
completed by an occupational therapist with clinical (NPV), the probability a workstation had no problem
and research experience in computer workstation as- area when the CWC identified no problem area, were
sessment. also calculated (Table 2).
Baseline digital photographs of the computer work- For the purposes of assessment of reliability and va-
station were taken by a trained research coordinator. lidity, analysis of all descriptive questions such as “Do
These photographs showed respondents seated at their you know how to operate your chair controls?” are not
computer workstations. Multiple shots were taken, in- provided here. Of primary interest was the ability of
cluding full body and close-up lateral views. The occu- the instrument to correctly identify (diagnose) the pres-
ence of the mismatches between the computer opera-
pational therapist used these photographs to assess the
tor and the workstation that might place the operator
workstation and identify if there were problems in 16
at risk for musculoskeletal disorders. Thus, only reli-
specific areas where mismatches between the worker
ability and validity were reported for the16 diagnostic
and workstation commonly occur. These 16 areas cor-
questions of the CWC. The reliability of other ques-
responded to 16 diagnostic items on the CWC (See Ta-
tions is provided in Appendix 1.
ble 2). The occupational therapist then conducted an
onsite workstation evaluation, assessing these16 spe-
cific areas to confirm that problem areas were correctly 3. Results
identified. This onsite workstation evaluation served as
the criterion reference gold standard to which the CWC Thirty respondents were recruited (Table 3). The
responses were compared. mean age of respondents was 47.2 years (SD, 10.6), 28
216 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist

Table 2
Reliability and validity of the computer workstation checklist (16 diagnostic questions)
Reliability Validity
CWC questions Kappa PABAK Sens Spec PPV NPV
Chair
Is your chair height adjusted so your feet are flat on the floor (or on a footrest) with your 0.34 0.66 0.25 1.00 1.00 0.40
back supported by the backrest?
With your back against the backrest, does the back of your knees extend at least 3 finger 0.58 0.59 0.91 0.79 0.71 0.94
widths past the front edge of your chair seat?
Is your chair seat a comfortable width for you? 0.35 0.79 1.00 1.00 1.00 1.00
Does your backrest support your entire back? 0.38 0.38 0.80 0.93 0.92 0.82
Is your armrest height approximately the same height as your keyboard height? 0.71 0.72 0.50 0.67 0.69 0.47
Keyboard
Is the height of your keyboard low enough so that your arms are relaxed at your sides with 0.39 0.53 0.27 1.00 1.00 0.33
your elbows bent at approximately 90◦ (right angle)?
Is your keyboard comfortable to use? 0.61 0.80 1.00 1.00 1.00 1.00
Input device
Is your input device positioned as close to your body as your keyboard? 0.63 0.67 0.62 0.94 0.89 0.76
Is the height of your input device low enough so that your arms are relaxed at your sides? 0.60 0.60 0.52 0.80 0.93 0.25
Is your input device comfortable to use? −0.07 0.73 0.50 1.00 1.00 0.93
Monitor
Is the viewing distance from your eyes to the monitor screen at your arm’s length away 0.52 0.53 0.56 0.86 0.82 0.63
(closed fist)?
Is your monitor positioned in front of you, so you do not have to turn your head or neck to 0.65 0.93 0.20 0.96 0.50 0.86
view it?
Is your monitor positioned so that the top of the monitor is at about eye level? 0.59 0.67 0.24 0.89 0.83 0.33
Computer table
Is your computer table large enough to accommodate work objects, and allow you to write 0.84 0.93 0.78 1.00 1.00 0.91
or perform tasks other than computer use?
Have you removed all under computer table obstructions? 0.48 0.53 0.63 0.91 0.71 0.87
Document holder
Do you need to use a document holder? 0.89 0.93 0.50 1.00 1.00 0.93
Note. CWC = Computer Workstation Checklist; PABAK = prevalence-adjusted bias-adjusted kappa; Sens = sensitivity; Spec = specificity;
PPV = positive predictive value; NPV = negative predictive value.

were female, and 25 were White. All respondents were one each for chair and keyboard, had 100% sensitiv-
employed full-time. The average number of years re- ity and specificity. The PPV was greater than the NPV
spondents used a computer at work was 15.1 (SD, 9.3) for all questions except three related to chair, monitor,
and time spent per day using a computer averaged 6.2 and computer table areas. There were 7 questions with
hours (SD, 1.6). 100% PPV and 2 questions with 100% NPV.
The PABAK scores for test-retest reliability collec-
tively ranged from fair to almost perfect (0.38 to 0.93;
Table 2). PABAK scores for setup of the chair (0.38 4. Discussion
to 0.79) ranged from fair to substantial and the key-
board (0.53 to 0.80) ranged from moderate to substan- Self-report checklists are commonly used to assist
tial. The PABAK scores for the input device (0.60 to computer operators identify if there are problems with
0.73), monitor (0.53 to 0.93), and computer table (0.53 workstation setup. Workers use the checklists to iden-
to 0.93) ranged from moderate to almost perfect. The tify problems and are expected to self-identify solu-
one question for the document holder had an almost tions for these problems. In some cases, computer op-
perfect PABAK score (0.93). erators identify problems and an expert uses this in-
Overall, the validity of the CWC demonstrated formation to develop solutions. The CWC uses typical
greater specificity than sensitivity for most items (Ta- questions seen in many of the current self-report instru-
ble 2). A score of greater than or equal to 0.90 was ments. The purpose of this study was twofold: 1) exam-
used as an indicator of excellent validity. Only 3 of ine the test-retest reliability of the CWC and 2) deter-
16 questions met this metric for sensitivity, while 11 mine the concurrent criterion validity of key CWC di-
of 16 questions met it for specificity. Two questions, agnostic questions by comparing the results of respon-
 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist 217

Table 3
Respondent demographic and clinical characteristics
gard to awareness of body position, and therefore may
be easier to understand. Completion of the CWC at
Demographic n (%)
Mean ± SD
baseline may have influenced respondents’ perceptions
Age 47.2 ± 10.6 of workstation setup, prompting respondents to make
Gender subtle changes to their workstation. The variability in
Male 2 (6.7) scores may then reflect true differences of the measures
Female 28 (93.3) when there was, in fact, a change to the workstation
Race setup.
Black or African American 4 (13.3)
The criterion validity of the CWC was much more
White 25 (83.3)
More than 1 answer 1 (3.3) accurate for specificity than sensitivity, indicating a
Highest level of education
high number of false negative outcomes. Respondents
Secondary 1 were more likely to indicate they had no problems with
Post high school 29 their workstation, whether they had problems or not.
Use of pain medication For clinical application, an instrument with very high
Prescription 2 specificity is most accurate identifying those who have
Non-prescription 9
Both 3
the problem of interest rather than ruling out those
who do not have problems. Items with high specificity
Level of discomfort
Eyes 1.85 ± 0.35 and low sensitivity have high positive predictive val-
Neck/Shoulders 2.67 ± 0.41 ues (PPV) and low negative predictive values (NPV).
Back 1.78 ± 0.31 While this would seem counterintuitive, it is an exam-
Right elbow/forearm/wrist/hand 2.59 ± 0.34
Left elbow/forearm/wrist/hand 1.93 ± 0.30
ple of the rule of SpPin described by Sackett and col-
leagues [14]. In SpPin when an item has high Speci-
Note. Level of discomfort scores collected from the Work Discom-
fort Survey. Higher scores indicate more discomfort on a 0–10 scale. ficity, a Positive response rules in the problem area. In
the case of the CWC, if respondents identified that they
dents’ self-report to the results of an onsite worksta- had problems with their workstation setup, it was al-
tion evaluation completed by an expert in ergonomic most certain that they did (PPV); whereas, if they iden-
assessment. The diagnostic questions were examined tified that they did not have problems with their work-
as these questions are ones that will be used to identify station setup, it was uncertain whether they did or did
problem areas that need remediation. If respondents not have a problem (NPV). Table 4 demonstrates why
cannot correctly identify problem areas, then they can- high specificity suggests that positive responses on the
not correctly remediate problems. CWC indicated problems at the workplace. Twenty-
Test-retest reliability is a measure of how consis- four people responded “no” on the CWC to the ques-
tently the CWC reproduced the same result following tion “Is the height of your keyboard low enough so that
repeated administration, given no true changes to the your arms are relaxed at your sides with your elbows
workstation setup. In general, the CWC items demon- bent at approximately 90◦ (right angle)?” Of those 24
strated moderate to near perfect reliability once we people, 8 actually did not have problems, while 16 ac-
controlled for prevalence and bias. The only exception tually did. Conversely, while only 6 people reported
was for the item related to the backrest (Does your “yes” they had problems; each of those 6 actually had
backrest support your entire back?). This question may problems with their keyboard height. Thus, the abil-
require further specification as to what constitutes the ity of respondents to self-identify problems using the
“entire back.” CWC is poor for many of the diagnostic questions.
Although the PABAK statistic was used to mini- This study design had several limitations with regard
mize the influence of prevalence and bias, variability to validity. Three criteria to judge the validity of an in-
of reliability across items remained. This variability strument are measurement, representation, and ascer-
may be explained by several factors. Of the CWC ar- tainment [15]. Measurement is whether the reference
eas that we assessed, items that addressed the moni- gold standard (i.e., the onsite workstation evaluation
tor and computer table had the strongest agreement. by the occupational therapist) was measured indepen-
This finding may reflect the stationary nature of these dent and blind of the CWC. Representation is whether
workstation items compared to the chair, keyboard, or the respondents were representative of the larger pop-
input device. Also, the monitor and computer table ulation for whom the CWC is intended. Ascertainment
are external points of reference to respondents in re- is whether the onsite workstation evaluation was com-
218 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist

Table 4
Keyboard height as an example of why a positive result on an instrument with high specificity indicates the presence of the disorder (SpPin)
Results of ergonomic assessment of computer
workstation (reference standard)
Problem No problem Total
Results of CWC Problem 6 0 6
No Problem 16 8 24
Total 22 8 30
Sensitivity, 6/22 = 0.27 Of respondents who had a problem with keyboard height only 27% were correctly identified by the CWC; Specificity,
8/8 = 1.00 Of respondents who did not have a problem with keyboard height 100% were correctly identified by the CWC; PPV, 6/6 = 1.00
100% of respondents who answered “yes” on the CWC actually had a problem with keyboard height; NPV, 16/24 = 0.33 33% of respondents
who answered “no” on the CWC actually had no problem with keyboard height.

pleted regardless of the results of the CWC and digital prioceptive abilities are altered when people experi-
photographs. The onsite evaluation was completed by ence pain [17]. The people most likely to be interested
the same occupational therapist who reviewed both the in adjusting their computer workstation, those experi-
baseline CWC and digital photographs. Therefore, the encing pain during computer use, therefore, are least
occupational therapist was not blind to potential work- likely to be able to accurately report their postures.
station problem areas at the onsite evaluation, which If the respondent identifies that they have a problem,
introduced bias (measurement). Additionally, the ref- this would be strong evidence to support an interven-
erence gold standard was based on clinical expertise, tion in that area (high PPV). However, if a respondent
not an objective measure. The intent of the study de- indicates that there was no problem, further evalua-
sign was to conduct a pilot test of the CWC, therefore, tion would be needed to ensure that problems were not
the number of respondents and convenient recruitment missed (low NPV). The CWC would benefit from fur-
places limitation on generalization of the sample to a ther consolidation to reduce the number of questions,
spectrum of the population (representation). There was
and further clarification to increase the specificity of
100% compliance with CWC completion and every
certain items. Additionally, identifying appropriate in-
participant received an onsite workstation evaluation,
terventions for problem areas should be studied further.
each independent of the other (ascertainment).
The results of this study do not support the use
of self-administered checklists to identify problem ar-
eas in computer workstations. While there have been Acknowledgements
no other studies in the peer-reviewed literature on the
validity of self-report for identifying computer work- The authors would like to acknowledge the Na-
station setup problems, the results of conference pro- tional Institute for Occupational Safety and Health
ceedings on ErgoFix, a computer workstation self- (NIOSH) (R01 OH008961) for providing funding for
assessment program, also found poor reliability in 6 this project.
out of 11 questions related to self-report of computer
related problems [16]. Thus, the usefulness of a self-
report computer workstation assessment appears to be
References
limited. Our results suggest that self-report should be
used as an adjunct to an assessment completed by an
[1] Cal/OSHA Consultation Service Research and Education
expert in computer workstation setup.
Unit. Easy ergonomics for desktop computer users. Depart-
This study considered whether the CWC could reli- ment of Industrial Relations; 2005 [cited 2010 February
ably and correctly identify problem areas in computer 25]; Available from: http://www.dir.ca.gov/dosh/dosh_publi
workstation setup. Overall, the evaluation of the psy- cations/ComputerErgo.pdf.
[2] Division of Occupational Health and Safety (DOHS). Er-
chometrics of the CWC suggests that respondents gen-
gonomics for computer workstations. Office of Research Ser-
erally answer items in a similar manner over time (re- vices; ND [cited 2010 February 25]; Available from: http://
liability), but that many of their answers are not valid. dohs.ors.od.nih.gov/ergo_computers.htm.
That, in fact, most respondents vastly underestimate [3] Ergonomics Working Group. Creating the ideal computer
workstation: A step-by-step guide. Department of Defense;
the number of problems there are with their worksta- 2002 [cited 2010 February 25]; Available from: http://www.
tion setup, particularly when they relate to subtle body ergoworkinggroup.org/ewgweb/SubPages/ProgramTools/
postures. Research on chronic pain suggests that pro- Publications/Workstation_Guide_Web.pdf.
 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist 219

[4] Occupational Safety and Health Administration. eTool – [10] Hernandez B, Keys C, Balcazar F. The Americans with Dis-
Computer workstations. United States Department of Labor; abilities Act Knowledge Survey: Strong psychometrics and
ND [cited 2010 February 25]; Available from: http://www. weak knowledge. Rehabil Psychol. 2003; 48(2): 93-9.
osha.gov/SLTC/etools/computerworkstations/index.html. [11] Janowitz I, Stern A, Morelli D, Vollowitz E, Hudes M, Rem-
[5] Schreuer N, Myhill WN, Aratan-Bergman T, Samant D, pel D, editors. Validation and field testing of an ergonomic
Blanck P. Workplace accommodations: Occupational thera- computer use checklist and guidebook, 2002.
pists as mediators in the interactive process. Work-a Journal of [12] Menendez CC, Amick BC, Chang C-H, Harrist R, Jenkins M,
Prevention Assessment and Rehabilitation. 2009; 34(2): 149- Robertson M, et al. Evaluation of two posture survey instru-
60. ments for assessing computing postures among college stu-
[6] Shaw WS, Feuerstein M. Generating workplace accommoda- dents. Work. 2009; 34(4): 412-30.
tions: Lessons learned from the integrated case management [13] Sims J, Wright CC. The kappa statistic in reliability stud-
study. Journal of Occupational Rehabilitation. 2004; 14(3): ies: Use, interpretation, and sample size requirments. Physical
207-16. Therapy. 2005; 85: 257-68.
[7] Brouwer B, Mazzoni C, Pearce GW. Tracking ability in sub- [14] Sackett DL HR, Guyatt GH, Tugwell P. Clinical epidemiol-
jects symptomatic of cumulative trauma disorder: does it re- ogy: A basic science for clinical medicine, 2nd ed., 1991 ed.
late to disability? Ergonomics. 2001; 44(4): 443-56. Boston: Little, Brown and Company, 1991.
[8] Juul-Kristensen B, Lund H, Hansen K, Christensen H, [15] Straus S, Richardson WS, Glasziou P, Haynes RB. Evidence-
Donneskiold-Samsoe B, Bliddal H. Poorer elbow propriocep- based medicine. Philadelphia: Elsevier, 2005.
tion in patients with lateral epicondylitis than in healthy con- [16] Pentikis J. ErgoFix: A field test of a computer workstation
trols: A cross-sectional study. J Shoulder Elbow Surg. 2008; self-assessment program. 2009 [cited 2012 July 23]; Available
17(1): 72S-81S. from: www.denix.osd.mil/ergoworkinggroup/upload/Ergo
[9] Shaw W, Hong QN, Pransky G, Loisel P. A literature review FIX-Pentikis.pdf.
describing the role of return-to-work coordinators in trial pro- [17] Nijs J, Daenen L, Cras P, Struyf F, Roussel N, Oostendorp
grams and interventions designed to prevent workplace dis- RAB. Nociception affects motor output: A review on sensory-
ability. Journal of Occupational Rehabilitation. 2008; 18(1): motor interaction with focus on clinical implications. Clin J
2-15. Pain. 2012; 28(2): 175-81.
220 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist

Appendix 1 Reliability of the computer workstation checklist

Reliability
CWC questions Kappa PABAK
Overall Workstation Problems
Is the work area large enough to accommodate you? 0.35 0.80
Does the work area provide enough room for your equipment and the materials that make up the workstation? 0.36 0.67
Are the items you use most often placed directly in front of you? 0.19 0.67
Do you use a headset for lengthy telephone work? 1.00 1.00
Chair
Is your chair easily adjustable, requiring the use of just one hand? 0.43 0.52
Are your chair’s controls easy to reach and adjustable from the standard seated work position? 0.63 0.72
Do your chair controls provide immediate feedback? 0.52 0.59
Is the operation of your chair’s controls logical and consistent? 0.70 0.72
Do you know how to operate your chair controls? 0.30 0.38
Is your chair height easily adjustable? 0.52 0.72
Is your chair padded? 1.00 1.00
Is the padding comfortable? 0.61 0.79
Is the front of your chair seat rounded? 0.65 0.93
Does your chair backrest support the curve of your back? 0.30 0.38
Does your backrest support your entire back? 0.38 0.38
Can your backrest move forward and back? 0.52 0.59
Does your chair back have lumbar (low back) support? 0.78 0.79
Can you adjust your lumbar (low back) support? 0.37 0.38
Is your lumbar (low back) support wide enough to comfortably support your low back? 0.33 0.45
Does your chair have armrests? −0.04 0.86
Do your armrests adjust? 0.70 0.72
Are your armrests removable? 0.72 0.72
Are your armrests low enough to fit under your work surface? 0.29 0.31
Are your armrests long enough to support your forearms? 0.61 0.66
Are your armrests padded and soft? 0.72 0.72
Is the distance between your armrests adjustable? 0.85 0.86
Does your chair roll without difficulty? 0.37 0.79
Does your chair have a stable base supported by five legs with casters? 0.00 0.79
Does your chair turn 360◦ ? 0.00 0.79
If your feet do not rest completely on the floor when the chair is properly adjusted, do you use a footrest? 0.70 0.72
Is your footrest large enough to support the soles of both feet? 0.56 0.59
Keyboard
Is the surface that you place your keyboard on stable? 0.78 0.93
Is the surface that you place your keyboard on large enough to hold your keyboard and an input device? 0.63 0.73
Is your keyboard detached from your monitor? −0.05 0.73
Is your keyboard easy to use? 1.00 1.00
Can you activate the keyboard keys without excessive force? 1.00 1.00
Do you rest your palm or wrist while typing? 0.60 0.67
Do your wrists or hands rest on sharp or hard edges? 0.29 0.60
Do you have a wrist rest for your keyboard? 0.87 0.87
Do you rest your elbows and/or forearms on a support (e.g., armrests) while you are using your keyboard? 0.60 0.60
Input device
Is your mouse located next to your keyboard on a work surface or tray? 0.76 0.87
Is your input device work surface stable? 0.37 0.80
Is your input device work surface large enough to comfortably manipulate the device? 0.63 0.87
Do you use a wrist rest with your input device? 0.92 0.93
Do you rest your elbows and/or forearms on a support (e.g., armrests) while you are using your input device? 0.60 0.60
Monitor
Is your monitor height adjustable? 0.80 0.93
Are the images displayed on your monitor clear? 0.00 0.87
Is the character size displayed on your monitor easy to read? −0.03 0.07
If you wear bifocals or trifocals, can you read the screen without bending your head or neck? −0.08 0.93
 N.A. Baker et al. / Reliability and concurrent validity of the Computer Workstation Checklist 221

Reliability
CWC questions Kappa PABAK
Computer table
Is your computer table surface large enough to accommodate a computer monitor and a separate adjustable 0.00 0.93
keyboard in front of you?
Is the space under your desk long enough to accommodate your leg length? 0.00 0.93
Do you have enough space between the top of your thighs and your computer table/keyboard platform (thighs are 0.27 0.73
not trapped)?
Is your computer table stable? 1.00 1.00
Is your computer table surface adjustable? 0.26 0.73
If your computer table has a fixed height, do you have an adjustable keyboard tray? 0.86 0.87
Document holder
Is your document holder positioned next to your monitor? 1.00 1.00
Is your document holder at the same height as your monitor? 0.00 0.17
Environmental factors
Is your room temperature comfortable? 0.73 0.73
Is the noise level in your workstation acceptable? 0.67 0.80
Is your monitor screen free of glare? 0.52 0.80
Have you arranged your workstation so that your monitor screen is not in front of a window? 0.82 0.89
Does your workstation have matte or nonglare surfaces? 0.68 0.73
Do you have blinds on the windows near your computer? 0.93 0.93
Work habits
Do you take short and frequent breaks every 20–30 minutes? 0.59 0.60
Do you frequently change your body positions while working? 0.68 0.73
Do you experience discomfort or pain while working on your computer? 0.68 0.73
Note. CWC = Computer Workstation Checklist.